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Organization
TRAC B WELLNESS
Active
Organization
TRAC B WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUADALUPE AVILA (OWNER)
(702) 488-6737
Entity
Organization
Contact information
Practice address
1513 S EASTERN AVE, LAS VEGAS, NV 89104-3916
(702) 488-6736
(702) 850-9105
Mailing address
5900 GORDON AVE, LAS VEGAS, NV 89108-2476
(702) 488-6737
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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