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NPI Code Detail

MEDICARE: NEVADA MENTAL HEALTH, LLC

MEDICARE: NEVADA MENTAL HEALTH, 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1427330067
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEVADA MENTAL HEALTH, LLC
Provider Business Mailing Address
First Line : 6889 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-4687
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6889 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-4687
Country : US
Telephone Number : 702-434-1200
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RON ZEDEK
Credential : MD
Telephone Number : 702-434-1200
Provider Enumeration Date : 09/09/2011
Last Update Date : 09/09/2011

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