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NPI Code Detail

MEDICARE: DISCOVERY MIND CENTER LTD

MEDICARE: DISCOVERY MIND CENTER LTD
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
1251S00000XCommunity/Behavioral Health Agency20150212668-83NV

General Provider Information

NPI Number : 1548648439
Entity Type Code : Organization
Provider Name (Legal Business Name) : DISCOVERY MIND CENTER LTD
Provider Business Mailing Address
First Line : 2021 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3137
Country : US
Telephone Number : 702-202-0099
Fax Number : 702-778-7632
Provider Business Practice Location Address
First Line : 2021 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3137
Country : US
Telephone Number : 702-202-0099
Fax Number : 702-778-7632
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. MATTHEW O OKEKE
Credential : MD
Telephone Number : 702-202-0099
Provider Enumeration Date : 05/11/2015
Last Update Date : 05/11/2015

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Directions to “DISCOVERY MIND CENTER LTD ” Practice Location

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