Organization
MAGDALENE CLINICAL CONSULTING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA DOLECKI CPB (BILLING SERVICES)
(814) 271-2011
Entity
Organization
Contact information
Practice address
3127 E WARM SPRINGS RD STE 300, LAS VEGAS, NV 89120-3134
(702) 850-8700
Mailing address
3127 E WARM SPRINGS RD STE 300, LAS VEGAS, NV 89120-3134
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN002022
STATE LICENSE
NV
Enumeration date
01/16/2019
Last updated
01/25/2019
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