Organization
MAPLE STAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MOUYIOS LCSW (DIRECT SUPERVISOR)
(702) 733-8098
Entity
Organization
Contact information
Practice address
1050 E FLAMINGO RD, SUITE S-107, LAS VEGAS, NV 89119-7427
(702) 733-8098
Mailing address
1050 E FLAMINGO RD, SUITE S-107, LAS VEGAS, NV 89119-7427
(702) 733-8098
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/24/2013
Last updated
10/24/2013
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