Provider Demographics
NPI:1083180178
Name:NEVADA MENTAL HEALTH LLC
Entity type:Organization
Organization Name:NEVADA MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-646-0188
Mailing Address - Street 1:8845 W FLAMINGO RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8745
Mailing Address - Country:US
Mailing Address - Phone:702-646-0188
Mailing Address - Fax:
Practice Address - Street 1:8845 W FLAMINGO RD STE 210
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8745
Practice Address - Country:US
Practice Address - Phone:702-646-0188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty