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General NPI Number Information
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NPI Number | 1215707831
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Entity Type | Organization
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Legal Business Name | MARIPOSA WELLNESS CENTER LLC
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Dates
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Enumeration Date | 01/04/2024
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 8360 W SAHARA AVE STE 230
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City | LAS VEGAS
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State | NV
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Zip | 89117-8945
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Country | US
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Telephone | 702-721-8329
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Fax |
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Provider Business Mailing Address
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Address Line | 11035 LAVENDER HILL DR STE 160
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City | LAS VEGAS
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State | NV
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Zip | 89135-2957
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Country | US
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Telephone | 702-721-8329
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | KRISTIN PARAGAS
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Credential | LCSW
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Telephone | 702-721-8329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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