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General NPI Number Information
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NPI Number | 1184132375
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Entity Type | Organization
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Legal Business Name | NEVADA PSYCHIATRIC SOLUTIONS CLINIC, LLC
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 2121 E FLAMINGO RD STE 108
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City | LAS VEGAS
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State | NV
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Zip | 89119-5123
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Country | US
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Telephone | 702-570-7646
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Fax | 702-749-6254
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Provider Business Mailing Address
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Address Line | 371 PEACH TREE DR
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City | HENDERSON
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State | NV
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Zip | 89014-5190
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Country | US
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Telephone | 702-353-1143
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Fax | 702-749-6254
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Authorized Official
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Title or Position | OWNER
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Name | JEHAN ALSMADI
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Credential |
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Telephone | 702-570-7646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20181040747
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License Number State | NV
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