Individual provider · Type 1 NPI

Oliver D. Cannon Jr., 22 YEARS PROF EXPERT

Community/Behavioral Health Agency · Las Vegas, NV

NPI number 1508779059 Active

Practice location

14050 Kyle Canton Rd
Las Vegas, NV 89166

Call (702) 301-5705 Map

Fax (702) 395-5800

Specialties and licenses

TaxonomyCodeLicense
Community/Behavioral Health Agency Primary 251S00000XNV20201957379 (NV)

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…

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About NPI 1508779059

Oliver D. Cannon Jr., 22 YEARS PROF EXPERT's National Provider Identifier is 1508779059, issued on Sep 25, 2026. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Las Vegas, NV. The record was last updated on Sep 25, 2026.