Organization
EBONNY BEHAVIORAL CARE SERVICES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FESTUS EBONKA APRN (PRESIDENT)
(702) 515-9680
Entity
Organization
Contact information
Practice address
1721 E CHARLESTON BLVD STE 300, LAS VEGAS, NV 89104-1902
(026) 850-6207
(702) 685-9674
Mailing address
1721 E CHARLESTON BLVD STE 300, LAS VEGAS, NV 89104-1902
(025) 159-6807
(702) 685-9674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
06/03/2016
Last updated
04/24/2025
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