Provider Demographics
NPI:1417478587
Name:MIND RELIEF LLC
Entity Type:Organization
Organization Name:MIND RELIEF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNAL-PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-272-8619
Mailing Address - Street 1:5509 DAMICO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2254
Mailing Address - Country:US
Mailing Address - Phone:702-272-8619
Mailing Address - Fax:
Practice Address - Street 1:3530 E FLAMINGO RD STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5008
Practice Address - Country:US
Practice Address - Phone:702-202-4240
Practice Address - Fax:702-680-1536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty