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Organization
WELLNESS SUPPORT SERVICES
Active
Organization
WELLNESS SUPPORT SERVICES
Active
Other names
MARIA JACKSON SOLE MBR
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JACKSON (OWNER)
(951) 400-8548
Entity
Organization
Contact information
Practice address
3930 E PATRICK LN, LAS VEGAS, NV 89120-4924
(951) 400-8548
Mailing address
3930 E PATRICK LN, LAS VEGAS, NV 89120-4924
(951) 400-8548
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
—
—
163WP0000X
Pain Management Registered Nurse
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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