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Individual

STEPHAN MELANCON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4000 E CHARLESTON BLVD, SUITE B-230, LAS VEGAS, NV 89104-6659
(702) 968-5000
(702) 968-5050
Mailing address
1255 S 8TH ST, LAS VEGAS, NV 89104-1546
(702) 672-1425

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
05/16/2007
Last updated
07/08/2007
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