Healthcare Provider Details

I. General information

NPI: 1982833778
Provider Name (Legal Business Name): URBAN SOCIAL SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 08/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 S JONES BLVD SUITE 227
LAS VEGAS NV
89146-3103
US

IV. Provider business mailing address

2350 S JONES BLVD SUITE 227
LAS VEGAS NV
89146-3103
US

V. Phone/Fax

Practice location:
  • Phone: 702-214-2140
  • Fax: 702-215-5801
Mailing address:
  • Phone: 702-214-2140
  • Fax: 702-215-5801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5341-C
License Number StateNV

VIII. Authorized Official

Name: JERRY STEELE
Title or Position: OWNER
Credential:
Phone: 702-214-2140