Provider Demographics
NPI:1942773858
Name:CORE MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:CORE MENTAL HEALTH SERVICES
Other - Org Name:CORE MENTAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GRISELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:702-756-6518
Mailing Address - Street 1:8670 SPRING MOUNTAIN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4102
Mailing Address - Country:US
Mailing Address - Phone:725-735-2700
Mailing Address - Fax:725-735-2703
Practice Address - Street 1:8670 SPRING MOUNTAIN RD STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-4102
Practice Address - Country:US
Practice Address - Phone:725-735-2700
Practice Address - Fax:725-735-2703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1942773858Medicaid
NV1356817597Medicaid