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General NPI Number Information
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NPI Number | 1790672491
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Entity Type | Organization
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Legal Business Name | MERCY MEDICAL AND BEHAVIORAL INC
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 2820 W CHARLESTON BLVD STE 40
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City | LAS VEGAS
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State | NV
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Zip | 89102-1934
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Country | US
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Telephone | 725-205-0288
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Fax | 725-204-9792
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Provider Business Mailing Address
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Address Line | 7521 SLIPPER ORCHID ST
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City | LAS VEGAS
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State | NV
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Zip | 89148-2616
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Country | US
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Telephone | 725-205-0288
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Fax | 725-204-9792
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Authorized Official
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Title or Position | PRESIDENT
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Name | CECILIO P GONZALES JR.
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Credential |
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Telephone | 725-205-0288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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