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Organization
JPLUS
Active
Organization
JPLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOJI OBAGBEMI (OWNER)
(702) 487-5541
Entity
Organization
Contact information
Practice address
3920 W CHARLESTON BLVD STE N, LAS VEGAS, NV 89102-1651
(702) 822-0447
Mailing address
3920 W CHARLESTON BLVD STE N, LAS VEGAS, NV 89102-1651
(702) 478-5541
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NV20181610830
—
NV
Enumeration date
06/10/2022
Last updated
06/15/2022
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