# KETAMINE WELLNESS CENTERS LAS VEGAS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KETAMINE WELLNESS CENTERS ARIZONA LLC
- **Other names:** Ketamine Wellness Centers
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588249320
- **Legal business name:** KETAMINE WELLNESS CENTERS ARIZONA LLC
- **Authorized official:** ANITA JERGER (EXECUTIVE ASSISTANT)
- **Authorized official phone:** (855) 538-9355

## Contact information

- **Practice address:** 7375 S PECOS RD STE 102, LAS VEGAS, NV 89120-3773
- **Practice address phone:** (480) 788-8539
- **Practice address fax:** (844) 538-9355
- **Mailing address:** 113 W HOOVER AVE STE 101, MESA, AZ 85210-5214
- **Mailing address phone:** (480) 788-8539

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/12/2021
- **Last updated:** 03/12/2021