Healthcare Provider Details

I. General information

NPI: 1487066585
Provider Name (Legal Business Name): A PLACE TO BE ME BEHAVIRAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2014
Last Update Date: 05/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 W COLTON AVE
N LAS VEGAS NV
89032-8230
US

IV. Provider business mailing address

617 W COLTON AVE
N LAS VEGAS NV
89032-8230
US

V. Phone/Fax

Practice location:
  • Phone: 702-410-4640
  • Fax:
Mailing address:
  • Phone: 702-410-4640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LEMONTE JEFFERSON
Title or Position: OWNER
Credential:
Phone: 702-410-4640