Provider Demographics
NPI:1306338348
Name:LEAN ON ME BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:LEAN ON ME BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WORTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-354-8688
Mailing Address - Street 1:2780 HOMESTEAD RD STE 209
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-5757
Mailing Address - Country:US
Mailing Address - Phone:702-354-8688
Mailing Address - Fax:
Practice Address - Street 1:2780 HOMESTEAD RD STE 209
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5757
Practice Address - Country:US
Practice Address - Phone:702-354-8688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health