Individual ProviderMaydelli MendozaCounselorBehavioral Health & Social Service ProvidersPractice Address6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146-1067(702) 437-4673(702) 243-7467PECOS EnrollmentBased on the most recent information from CMS, provider Maydelli Mendoza does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1861036709Provider TypeIndividualFull NameMendoza, MaydelliGenderFemaleSole ProprietorNoEnumeration Date11/4/2019Last Updated7/26/2021Contact InformationPractice LocationPractice Address6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146-1067Phone(702) 437-4673FaxUnlisted FaxMailing LocationMailing Address6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146-1067Phone(702) 243-7467FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense101YM0800XNevadaCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer