Organization
NO LONGER BROKEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MORGAN RODRIGUEZ (DIRECTOR)
(702) 368-2380
Entity
Organization
Contact information
Practice address
7220 S CIMARRON RD STE 210, LAS VEGAS, NV 89113-2102
(702) 368-2380
Mailing address
7220 S CIMARRON RD STE 210, LAS VEGAS, NV 89113-2102
(702) 368-2380
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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