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General NPI Number Information
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NPI Number | 1518383892
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Entity Type | Organization
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Legal Business Name | CLEAR MINDS LLC
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 3636 LAS VEGAS BLVD N
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City | LAS VEGAS
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State | NV
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Zip | 89115-1555
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Country | US
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Telephone | 702-776-8397
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Fax | 702-643-6509
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Provider Business Mailing Address
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Address Line | 3636 LAS VEGAS BLVD N
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City | LAS VEGAS
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State | NV
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Zip | 89115-1555
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Country | US
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Telephone | 702-776-8397
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Fax | 702-643-6509
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Authorized Official
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Title or Position | ATTORNEY
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Name | JOSEPH IARUSSI
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Credential | ESQ.
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Telephone | 702-473-9640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | NV20141094855
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License Number State | NV
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