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General NPI Number Information
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NPI Number | 1609657972
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Entity Type | Organization
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Legal Business Name | CLEAR MIND MENTAL HEALTH LLC
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 1951 WAGONWHEEL AVE
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City | LAS VEGAS
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State | NV
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Zip | 89119-2873
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Country | US
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Telephone | 702-416-6290
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Fax |
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Provider Business Mailing Address
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Address Line | 1951 WAGONWHEEL AVE
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City | LAS VEGAS
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State | NV
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Zip | 89119-2873
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Country | US
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Telephone | 702-416-6290
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HELEN AMORES SAN JUAN
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Credential |
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Telephone | 702-416-6290
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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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