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General NPI Number Information
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NPI Number | 1700495884
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Entity Type | Organization
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Legal Business Name | FMT BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 07/24/2020
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Last Update Date | 08/06/2020
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Provider Practice Location Address
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Address Line | 4170 S DECATUR BLVD STE A6
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City | LAS VEGAS
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State | NV
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Zip | 89103-5862
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Country | US
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Telephone | 702-789-8038
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Fax | 702-436-5615
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Provider Business Mailing Address
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Address Line | 1012 BISTRO BAY AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-1337
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Country | US
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Telephone | 702-789-8038
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Fax | 702-436-5615
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Authorized Official
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Title or Position | CEO
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Name | MRS. FRANCISCA IYERE
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Credential |
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Telephone | 702-789-8038
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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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