Healthcare Provider Details

I. General information

NPI: 1275906521
Provider Name (Legal Business Name): TOURO UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2015
Last Update Date: 11/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 AMERICAN PACIFIC DR
HENDERSON NV
89014-8800
US

IV. Provider business mailing address

PO BOX 531730
HENDERSON NV
89053-1730
US

V. Phone/Fax

Practice location:
  • Phone: 702-777-4808
  • Fax: 702-777-4818
Mailing address:
  • Phone: 702-777-9967
  • Fax: 702-777-2069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. CRAIG M SEIDEN
Title or Position: VICE PRESIDENT FOR FINANCE & ADMIN
Credential: CPA
Phone: 702-777-4794