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Organization
BODY MIND AND WELLNESS CLINIC INCORPORATED
Active
Organization
BODY MIND AND WELLNESS CLINIC INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN GIL LLANES (OWNER AND DIRECTOR)
(702) 376-2485
Entity
Organization
Contact information
Practice address
2810 W CHARLESTON BLVD STE 57, LAS VEGAS, NV 89102-1906
(702) 376-2485
Mailing address
2810 W CHARLESTON BLVD STE 57, LAS VEGAS, NV 89102-1906
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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