Organization
PEDIATRIC BEHAVIOR MANAGEMENT PROFESSIONALS
Active
Other names
PBMP
Organization subpart
No
Provider details
NPI number
Authorized official
JERVON SLACK (OWNER)
(702) 473-8222
Entity
Organization
Contact information
Practice address
3651 LINDELL RD, STE D, LAS VEGAS, NV 89103-1254
(702) 473-8222
Mailing address
3651 LINDELL RD, STE D, LAS VEGAS, NV 89103-1254
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/07/2013
Last updated
11/13/2013
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