Provider Demographics
NPI:1184132375
Name:NEVADA PSYCHIATRIC SOLUTIONS CLINIC, LLC
Entity type:Organization
Organization Name:NEVADA PSYCHIATRIC SOLUTIONS CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSMADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-570-7646
Mailing Address - Street 1:371 PEACH TREE DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-5190
Mailing Address - Country:US
Mailing Address - Phone:702-353-1143
Mailing Address - Fax:702-749-6254
Practice Address - Street 1:2121 E FLAMINGO RD STE 108
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5123
Practice Address - Country:US
Practice Address - Phone:702-570-7646
Practice Address - Fax:702-749-6254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV201810407472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty