Organization
STARK MEDICINE
Active
Other names
Nevada Mental Health, Nevada Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA MARIE WILKINS (CREDENTIALING)
(206) 755-1879
Entity
Organization
Contact information
Practice address
526 S TONOPAH DR STE 200, LAS VEGAS, NV 89106-4013
(725) 246-1483
(702) 440-8430
Mailing address
840 S RANCHO DR STE 4-903, LAS VEGAS, NV 89106-3837
(702) 440-8840
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902149248
—
NV
05
—
832602698
—
NV
Enumeration date
04/23/2021
Last updated
10/01/2021
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