Healthcare Provider Details

I. General information

NPI: 1376134866
Provider Name (Legal Business Name): ALL TRIBEZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 E FLAMINGO RD STE 311
LAS VEGAS NV
89121-5067
US

IV. Provider business mailing address

3430 E FLAMINGO RD STE 311
LAS VEGAS NV
89121-5067
US

V. Phone/Fax

Practice location:
  • Phone: 725-204-7591
  • Fax: 702-920-8493
Mailing address:
  • Phone: 725-204-7591
  • Fax: 702-920-8493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMBERLY RENEE STANFILL
Title or Position: CO-OWNER
Credential:
Phone: 725-204-7591