Provider Demographics
NPI:1063140812
Name:CARDINAL MENTAL HEALTHCARE LLC
Entity type:Organization
Organization Name:CARDINAL MENTAL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHUA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, DNP
Authorized Official - Phone:702-485-3646
Mailing Address - Street 1:PO BOX 34736
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-4736
Mailing Address - Country:US
Mailing Address - Phone:702-485-3646
Mailing Address - Fax:702-485-3664
Practice Address - Street 1:3909 S MARYLAND PKWY STE 405
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7526
Practice Address - Country:US
Practice Address - Phone:702-485-3646
Practice Address - Fax:702-485-3664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)