MEDICARE: CLARK COUNTY BEHAVIORAL HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1144792326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARK COUNTY BEHAVIORAL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	2375 E TROPICANA AVE # 144
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6564
Country	:	US
Telephone Number	:	702-244-0665
Fax Number	:

Provider Business Practice Location Address
First Line	:	2375 E TROPICANA AVE # 144
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6564
Country	:	US
Telephone Number	:	702-244-0665
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	OMAR ALCID
Credential	:	MBA
Telephone Number	:	702-244-0665

Provider Enumeration Date	:	12/28/2018
Last Update Date	:	12/28/2018

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