Healthcare Provider Details

I. General information

NPI: 1952494049
Provider Name (Legal Business Name): REACHING OUR COMMUNITY'S KIDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 03/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 N PECOS RD SUITE 112
LAS VEGAS NV
89101-4887
US

IV. Provider business mailing address

51 N PECOS RD SUITE 112
LAS VEGAS NV
89101-4887
US

V. Phone/Fax

Practice location:
  • Phone: 702-837-3788
  • Fax: 702-438-9729
Mailing address:
  • Phone: 702-837-3788
  • Fax: 702-438-9729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHLEEN LOVE
Title or Position: PROGRAM DIRECTOR
Credential: MS/LSW
Phone: 702-837-3788