Healthcare Provider Details

I. General information

NPI: 1700046372
Provider Name (Legal Business Name): LONDON FAMILY AND CHILDREN'S SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 SILVERTON DR
HENDERSON NV
89074-1550
US

IV. Provider business mailing address

2026 SILVERTON DR
HENDERSON NV
89074-1550
US

V. Phone/Fax

Practice location:
  • Phone: 702-617-3466
  • Fax:
Mailing address:
  • Phone: 702-617-3466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License NumberGF1254021140001
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License NumberGF1254021140001
License Number StateNV

VIII. Authorized Official

Name: ROY RAY
Title or Position: CEO/PRESIDENT
Credential:
Phone: 702-617-3466