Provider Demographics
NPI:1447612718
Name:MINGO HEALTH SOLUTIONS
Entity type:Organization
Organization Name:MINGO HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DINISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY-MINGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-556-2634
Mailing Address - Street 1:4000 S EASTERN AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0847
Mailing Address - Country:US
Mailing Address - Phone:170-255-6263
Mailing Address - Fax:
Practice Address - Street 1:4000 S EASTERN AVE STE 240
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0847
Practice Address - Country:US
Practice Address - Phone:170-255-6263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20161175420251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health