CORNELL JEFFERSON

Community Based Residential Treatment Facility, Mental Illness

Active Individual
NPI: 1396004263

Practice Address

4915 E RUSSELL RD APT 125
Las Vegas, NV 89120

Phone: (702) 788-0091

Specialties

Specialty Code Primary License
Community Based Residential Treatment Facility, Mental Illness 320800000X Yes 320800000X (NV)

Frequently Asked Questions

NPI 1396004263 is the National Provider Identifier for CORNELL JEFFERSON, a Community Based Residential Treatment Facility, Mental Illness provider located in Las Vegas, NV. This NPI was enumerated on May 11, 2012.
CORNELL JEFFERSON practices at 4915 E RUSSELL RD APT 125, Las Vegas, NV 89120.

Quick Facts

NPI
1396004263
Type
Individual
Enumerated
May 11, 2012
Last Updated
May 11, 2012

Nearby Providers