Organization
MAXIMUMTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDA HAZELWOOD QMHA (MGR)
(702) 378-4824
Entity
Organization
Contact information
Practice address
840 S RANCHO DR # 4-312, LAS VEGAS, NV 89106-3837
(702) 468-3656
Mailing address
840 S RANCHO DR # 4-312, LAS VEGAS, NV 89106-3837
(702) 468-3656
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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