Provider Demographics
NPI:1699253518
Name:MIND AND BODY BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:MIND AND BODY BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIGI
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-478-7444
Mailing Address - Street 1:2360 E. CALVADA BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048
Mailing Address - Country:US
Mailing Address - Phone:702-444-7744
Mailing Address - Fax:702-444-7898
Practice Address - Street 1:2360 E. CALVADA BLVD
Practice Address - Street 2:STE B
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048
Practice Address - Country:US
Practice Address - Phone:702-444-7744
Practice Address - Fax:702-444-7898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNSELLING THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health