Organization
OPTIMAL MENTAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUNACHI EZENWATA (NURSE PRACTITIONER)
(725) 200-1050
Entity
Organization
Contact information
Practice address
4760 S PECOS RD, LAS VEGAS, NV 89121-6038
(725) 200-1050
Mailing address
PO BOX 3055 SAINT ROSE PARKWAY, HENDERSON, NV 89077
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
02/14/2024
Last updated
02/23/2026
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