Healthcare Provider Details

I. General information

NPI: 1710318092
Provider Name (Legal Business Name): NEVADA SENIOR SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NEVADA STATE DR
HENDERSON NV
89002-9725
US

IV. Provider business mailing address

901 N JONES BLVD
LAS VEGAS NV
89108-1603
US

V. Phone/Fax

Practice location:
  • Phone: 702-368-2273
  • Fax: 702-243-2273
Mailing address:
  • Phone: 702-648-3425
  • Fax: 702-648-1408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. LES JACOBS
Title or Position: CFO
Credential:
Phone: 70264834256