Organization
PURE HEARTS BEHAVIORAL HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKI LASHAWN HARRELL (PROVIDER)
(720) 885-0827
Entity
Organization
Contact information
Practice address
4325 W ROME BLVD, UNIT 1184, NORTH LAS VEGAS, NV 89084-5497
(702) 885-0827
(702) 405-9967
Mailing address
4325 W ROME BLVD, UNIT 1184, NORTH LAS VEGAS, NV 89084-5497
(702) 885-0827
(702) 405-9967
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790106821
—
NV
Enumeration date
01/26/2014
Last updated
01/26/2014
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