Organization
CANDLELIGHT MENTAL HEALTH COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIBA NEOMI AMEZCUA (CEO)
(702) 738-9064
Entity
Organization
Contact information
Practice address
5258 S EASTERN AVE STE 105, LAS VEGAS, NV 89119-2327
(702) 464-5080
Mailing address
700 ROCKY TRAIL RD, HENDERSON, NV 89014-0321
(702) 738-9064
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NV20191376022
—
NV
Enumeration date
05/22/2019
Last updated
05/22/2019
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