Provider Demographics
NPI:1609657972
Name:CLEAR MIND MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:CLEAR MIND MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMORES SAN JUAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-416-6290
Mailing Address - Street 1:1951 WAGONWHEEL AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-2873
Mailing Address - Country:US
Mailing Address - Phone:702-416-6290
Mailing Address - Fax:
Practice Address - Street 1:1951 WAGONWHEEL AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-2873
Practice Address - Country:US
Practice Address - Phone:702-416-6290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)