MEDICARE: MAJESTIC BEHAVIORAL HEALTH

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	1039	NV

General Provider Information

NPI Number	:	1932247442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAJESTIC BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	7464 W. SAHARA AVE
Second Line	:	SUITE 4
City	:	LAS VEGAS
State	:	NV
Zip	:	89117
Country	:	US
Telephone Number	:	702-869-4300
Fax Number	:	702-869-4301

Provider Business Practice Location Address
First Line	:	7464 W SAHARA AVE
Second Line	:	SUITE 4
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2740
Country	:	US
Telephone Number	:	702-869-4300
Fax Number	:	702-869-4301

Authorized Official
Title or Position	:	LMFT
Name	:	MRS. CONSTANCE FIELD
Credential	:
Telephone Number	:	702-869-4300

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	08/22/2020

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