Healthcare Provider Details

I. General information

NPI: 1033864608
Provider Name (Legal Business Name): JIREH SERVICES CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2022
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6895 E LAKE MEAD BLVD STE 6-154
LAS VEGAS NV
89156-1189
US

IV. Provider business mailing address

6895 E LAKE MEAD BLVD STE 6-154
LAS VEGAS NV
89156-1189
US

V. Phone/Fax

Practice location:
  • Phone: 702-281-7062
  • Fax:
Mailing address:
  • Phone: 702-281-7062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: LARHONYA RICHARDS
Title or Position: PRESIDENT
Credential:
Phone: 702-281-7062