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General NPI Number Information
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NPI Number | 1356050884
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Entity Type | Individual
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Provider Name | GUISEPPE MANDELL PERR RECOVERY SUPPOR
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Gender | Male
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Dates
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Enumeration Date | 11/23/2022
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 900 KAREN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89109-1264
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Country | US
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Telephone | 702-290-9952
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Fax |
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Provider Business Mailing Address
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Address Line | 900 KAREN AVE STE B202
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City | LAS VEGAS
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State | NV
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Zip | 89109-1274
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Country | US
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Telephone | 702-472-6248
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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