Organization
PEOPLES CHURCH
Active
Other names
TIDEWATER WELLNESS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDRA PLATZ (OWNER)
(413) 687-0507
Entity
Organization
Contact information
Practice address
304 S JONES BLVD, LAS VEGAS, NV 89107-2623
(413) 687-0507
Mailing address
304 S JONES BLVD, LAS VEGAS, NV 89107-2623
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TF0000X
Family Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
06/11/2021
Last updated
06/11/2021
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