Provider Demographics
NPI:1912364985
Name:EOS MENTAL HEALTH AND REHABILITATION SERVICES
Entity Type:Organization
Organization Name:EOS MENTAL HEALTH AND REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERZH
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAKELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-885-4454
Mailing Address - Street 1:3340 TOPAZ ST
Mailing Address - Street 2:STE 170
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3903
Mailing Address - Country:US
Mailing Address - Phone:702-885-4454
Mailing Address - Fax:702-297-6509
Practice Address - Street 1:3340 TOPAZ ST
Practice Address - Street 2:STE 170
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3903
Practice Address - Country:US
Practice Address - Phone:702-885-4454
Practice Address - Fax:702-297-6509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20151745454251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health