Organization
PROVIDENCE MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERCEDES WILLIAMS (OWNER)
(702) 689-3475
Entity
Organization
Contact information
Practice address
5615 TETON GLACIER ST, LAS VEGAS, NV 89148-7710
(702) 689-3475
Mailing address
5615 TETON GLACIER ST, LAS VEGAS, NV 89148-7710
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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