person
Cornell Leon Jefferson
Mental Illness Community Based Residential Treatment Facility in Las Vegas, Nevada
NPI 1396004263

Cornell Leon Jefferson is a Mental Illness Community Based Residential Treatment Facility based in Las Vegas, NV. Cornell Leon Jefferson practices in Las Vegas, NV. The NPI Number for Cornell Leon Jefferson is 1396004263 and holds a License No. 320800000X (Nevada).

The current practice location address for Cornell Leon Jefferson is 4915 E Russell Rd Apt 125, Las Vegas, NV and can be reached out via phone at 702-788-0091. You can also correspond with Cornell Leon Jefferson through the mailing address at 4915 E RUSSELL RD APT 125, LAS VEGAS, NV - 89120-2387 (mailing address contact number: 702-788-0091).

Location: 4915 E Russell Rd Apt 125, Las Vegas, NV, 89120-2387
person
Provider Profile Details
NPI Number
1396004263
Provider Name
Cornell Leon Jefferson
Credential
Provider Entity Type
Individual
Gender
Male
Address
4915 E Russell Rd Apt 125, Las Vegas, NV, 89120-2387
Phone Number
702-788-0091
Fax Number
Provider Enumeration Date
05/11/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4915 E Russell Rd Apt 125
City
State
Zip
89120-2387
Phone Number
702-788-0091
Fax Number
person
Provider Business Mailing Address Details
Address
4915 E Russell Rd Apt 125
City
State
Zip
89120-2387
Phone Number
702-788-0091
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
License No.
320800000X (Nevada)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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