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Organization
STARK MEDICINE
Active
Organization
STARK MEDICINE
Active
Other names
Nevada Mental Health, Nevada Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA MARIE WILKINS (CREDENTIALING)
(206) 755-1879
Entity
Organization
Contact information
Practice address
526 S TONOPAH DR STE 200, LAS VEGAS, NV 89106-4013
(725) 246-1483
(702) 440-8430
Mailing address
840 S RANCHO DR STE 4-903, LAS VEGAS, NV 89106-3837
(702) 440-8840
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902149248
—
NV
05
—
832602698
—
NV
Enumeration date
04/23/2021
Last updated
10/01/2021
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