Healthcare Provider Details

I. General information

NPI: 1134635436
Provider Name (Legal Business Name): TRUE HEARTS BEHAVORIAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2017
Last Update Date: 12/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3663 E SUNSET RD
LAS VEGAS NV
89120-3218
US

IV. Provider business mailing address

6501 VEGAS DR
LAS VEGAS NV
89108-7732
US

V. Phone/Fax

Practice location:
  • Phone: 702-338-4394
  • Fax:
Mailing address:
  • Phone: 702-338-4394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE A WASHINGTON
Title or Position: MANAGER
Credential:
Phone: 702-338-4394