Organization
ENLIGHTENED PATH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YAUNCAY J LUCAS (OWNER CFO/CEO)
(505) 814-9745
Entity
Organization
Contact information
Practice address
5544 MYRON CIR, LAS VEGAS, NV 89142-1123
(505) 814-9745
Mailing address
5544 MYRON CIR, LAS VEGAS, NV 89142-1123
(505) 814-9745
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NV
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NV
Other
Enumeration date
04/29/2016
Last updated
04/29/2016
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