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Organization

MOUNTAIN INTERVAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID CLARK MA (MANAGING PARTNER)
(702) 991-3150
Entity
Organization

Contact information

Practice address
4425 S JONES BLVD, SUITE D3, LAS VEGAS, NV 89103-3370
(702) 991-3150
(866) 658-4052
Mailing address
4425 S JONES BLVD, SUITE # D3, LAS VEGAS, NV 89103-3370
(702) 991-3150
(866) 658-4052

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
08/28/2010
Last updated
03/22/2017
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