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Organization
TELELAB
Active
Organization
TELELAB
Active
Other names
Body and Mind Health Partners
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA WALKER (OWNER)
(702) 901-9081
Entity
Organization
Contact information
Practice address
6889 W CHARLESTON BLVD STE A, LAS VEGAS, NV 89117-1644
(702) 779-3582
(702) 508-2435
Mailing address
7881 W CHARLESTON BLVD STE 230, LAS VEGAS, NV 89117-8327
(702) 508-2153
(702) 508-2435
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NV20201850927
BUSINESS LICENSE
NV
Enumeration date
07/27/2020
Last updated
03/11/2021
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