Organization
EBENEZER MEDICAL CENTER LLC
Active
Organization
EBENEZER MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAREL HERNANDEZ LEON (MANAGING MEMBER)
(702) 515-9926
Entity
Organization
Contact information
Practice address
2619 W CHARLESTON BLVD STE E, LAS VEGAS, NV 89102-2121
(702) 805-3059
Mailing address
305 ANTELOPE WAY, LAS VEGAS, NV 89145-5201
(702) 515-9926
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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