Provider Demographics
NPI:1770022725
Name:CLEAR MINDS FAMILY CENTER LLC
Entity Type:Organization
Organization Name:CLEAR MINDS FAMILY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NASTAZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-445-5466
Mailing Address - Street 1:PO BOX 753654
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89136-3654
Mailing Address - Country:US
Mailing Address - Phone:702-445-5466
Mailing Address - Fax:702-202-3411
Practice Address - Street 1:5550 W FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2334
Practice Address - Country:US
Practice Address - Phone:702-463-4000
Practice Address - Fax:702-463-4460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health