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General NPI Number Information
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NPI Number | 1962218818
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Entity Type | Organization
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Legal Business Name | STRONG MENTALITY
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 2610 S JONES BLVD STE 1F
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City | LAS VEGAS
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State | NV
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Zip | 89146-5635
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Country | US
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Telephone | 725-301-1182
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Fax |
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Provider Business Mailing Address
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Address Line | 2619 W CHARLESTON BLVD STE F
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City | LAS VEGAS
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State | NV
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Zip | 89102-2121
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | YAMIRYS LARA
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Credential |
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Telephone | 615-243-5519
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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