Organization
AVANT-GARDE CENTER FOR WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANESSA C PARKER PHD,MSN,MA,PMHNP-BC (PRESIDENT,CEO)
(323) 252-4569
Entity
Organization
Contact information
Practice address
1510 W SUNSET RD STE 110, HENDERSON, NV 89014-2695
(888) 375-8698
(702) 342-8108
Mailing address
1510 W SUNSET RD STE 110, HENDERSON, NV 89014-2695
(888) 375-8698
(702) 342-8108
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235795824
—
NV
Enumeration date
05/19/2019
Last updated
08/19/2020
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