Organization
PRIMEWELL SOLUTIONS BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE ANTONIO DIAGO (MANAGING MEMBER)
(702) 350-8216
Entity
Organization
Contact information
Practice address
421 S DECATUR BLVD, LAS VEGAS, NV 89107-2812
(702) 462-2325
Mailing address
6385 BLACK SWAN LN, LAS VEGAS, NV 89118-1998
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
04/03/2024
Last updated
10/01/2024
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