Organization
LIONS CREST LLC
Active
Organization
LIONS CREST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WASCAR CRUZ (OWNER)
(702) 772-8892
Entity
Organization
Contact information
Practice address
5420 W SAHARA AVE, SUITE 102, LAS VEGAS, NV 89146-0394
(702) 772-8892
Mailing address
5420 W SAHARA AVE, SUITE 102, LAS VEGAS, NV 89146-0394
(702) 772-8892
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/18/2012
Last updated
10/16/2013
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