Organization
GERONA PORCEL LLC
Active
Other names
Light Behavioral Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH BERNAL PEREZ (MANAGING MEMBER)
(702) 272-8619
Entity
Organization
Contact information
Practice address
2110 E FLAMINGO RD STE 205, LAS VEGAS, NV 89119-5192
(702) 620-5105
Mailing address
1912 MAGNOLIA DR, HENDERSON, NV 89014-5192
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
09/20/2019
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