Organization
WATERFALL BEHAVIORAL HEALTH SERVICES
Active
Other names
WATERFALL BEHAVIORAL HEALTH SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA MOQUETE (ADMINISTRATOR/OWNER)
(702) 929-6316
Entity
Organization
Contact information
Practice address
4760 S PECOS RD STE 103-19, LAS VEGAS, NV 89121-6038
(702) 207-1005
Mailing address
4760 S PECOS RD STE 103-19, LAS VEGAS, NV 89121-6038
(702) 207-1005
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NV20181152974
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538530514
—
NV
Enumeration date
03/01/2018
Last updated
06/16/2018
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