Organization
NEVADA FAMILY PRACTICE RESIDENCY PROGRAM, INC.
Active
Other names
Mojave Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES R PARCELLS LISW (PRESIDENT)
(702) 968-5059
Entity
Organization
Contact information
Practice address
4000 E CHARLESTON BLVD, SUITE 230, LAS VEGAS, NV 89104-6659
(702) 968-5059
(702) 968-4041
Mailing address
4000 E CHARLESTON BLVD, SUITE 230, LAS VEGAS, NV 89104-6659
(702) 968-5059
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100507624
—
NV
05
—
100507625
—
NV
05
—
100507626
—
NV
05
—
100507627
—
NV
05
—
100507628
—
NV
05
—
100507629
—
NV
05
—
100508048
—
NV
05
—
100508688
—
NV
05
—
100508689
—
NV
Enumeration date
07/11/2006
Last updated
06/17/2008
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