Organization
EPIC TRANSFORMATION WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ILLYAS MALIK JENKINS QMHA (CEO/FOUNDER)
(954) 380-0875
Entity
Organization
Contact information
Practice address
2620 REGATTA DR, LAS VEGAS, NV 89128-6891
(954) 380-0875
Mailing address
8904 TRICKLING SPRINGS CT, LAS VEGAS, NV 89149-2991
(954) 380-0875
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/21/2025
Last updated
05/21/2025
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