Organization
JEFFERSON FAMILY CORPORATION, INC
Active
Parent organization
JEFFERSON FAMILY CORPORATION, INC
Other names
Cognisive Clinic: The Center for Brain Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
JEFFERSON FAMILY CORPORATION, INC
Authorized official
ANNIE MAE SPENCER (OWNER)
(702) 684-3573
Entity
Organization
Contact information
Practice address
304 S. JONES BLVD, SUITE #3673, LAS VEGAS, NV 89107
(702) 684-3573
(702) 548-6891
Mailing address
304 S. JONES BLVD., SUITE #3673, LAS VEGAS, NV 89107
(702) 684-3573
(702) 548-6891
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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