Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cornell Leon Jefferson

Individual provider Mental Illness Community Based Residential Treatment Facility · NPI 1396004263

Cornell Leon Jefferson is a Mental Illness Community Based Residential Treatment Facility in Las Vegas, Nevada. Practices as a sole proprietor. Licensed in Nevada.

Licensed in
NV
In the registry since
2012

Practice location Address checks out

4915 E Russell Rd Apt 125
Las Vegas, NV 89120-2387
Phone: (702) 788-0091
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Illness Community Based Residential Treatment Facility (primary) Taxonomy 320800000X · Licence 320800000X (NV)

Record details

NPI number1396004263
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 11, 2012
Last updated in NPPESMay 11, 2012

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