# ETERNITY HEALTH WELLNESS CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568956498
- **Authorized official:** LACONJA BROOKS (MANAGER)
- **Authorized official phone:** (702) 272-9079

## Contact information

- **Practice address:** 6332 LEGEND FALLS ST, NORTH LAS VEGAS, NV 89081-6621
- **Practice address phone:** (702) 272-9079
- **Mailing address:** 6332 LEGEND FALLS ST, NORTH LAS VEGAS, NV 89081-6621
- **Mailing address phone:** (702) 272-9079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 06/14/2018
- **Last updated:** 06/14/2018