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Organization

PENNYWELL BEHAVIORAL HEALTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHILLIP WASHINGTON SR. (OWNER/PROVIDER)
(714) 499-6232
Entity
Organization

Contact information

Practice address
5025 NELLIS OASIS LN APT 244, LAS VEGAS, NV 89115-0770
(714) 499-6232
Mailing address
5025 NELLIS OASIS LN APT 244, LAS VEGAS, NV 89115-0770
(714) 499-6232

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251C00000X
Developmentally Disabled Services Day Training Agency
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
07/23/2015
Last updated
07/23/2015
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