Healthcare Provider Details

I. General information

NPI: 1225652316
Provider Name (Legal Business Name): LAUREN SCHLOSS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S JONES BLVD STE J
LAS VEGAS NV
89146-3165
US

IV. Provider business mailing address

3132 MEDITERRANEAN DR
LAS VEGAS NV
89117-2331
US

V. Phone/Fax

Practice location:
  • Phone: 702-523-0901
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: LAUREN SCHLOSS
Title or Position: DUAL DIAGNOSIS COUNSELOR
Credential: MRC, LADC, CPCI
Phone: 702-523-0901