Provider Demographics
NPI:1427603141
Name:M&M'S BEHAVIORAL MANAGEMENT
Entity Type:Organization
Organization Name:M&M'S BEHAVIORAL MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-964-6275
Mailing Address - Street 1:820 S 7TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-6939
Mailing Address - Country:US
Mailing Address - Phone:702-366-0474
Mailing Address - Fax:
Practice Address - Street 1:820 S 7TH ST STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6939
Practice Address - Country:US
Practice Address - Phone:702-366-0474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health