Provider Demographics
NPI:1639404213
Name:MAJESTIC MENTAL HEALTH
Entity Type:Organization
Organization Name:MAJESTIC MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:KNIGHT
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:702-869-4300
Mailing Address - Street 1:3680 N RANCHO DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130
Mailing Address - Country:US
Mailing Address - Phone:702-869-4300
Mailing Address - Fax:
Practice Address - Street 1:3680 N RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3180
Practice Address - Country:US
Practice Address - Phone:702-869-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01039251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health