Healthcare Provider Details

I. General information

NPI: 1619494341
Provider Name (Legal Business Name): WE ARE HOPE TRANSITIONAL LIVING SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 MONTESSOURI ST
LAS VEGAS NV
89117-3059
US

IV. Provider business mailing address

2575 MONTESSOURI ST
LAS VEGAS NV
89117-3059
US

V. Phone/Fax

Practice location:
  • Phone: 702-485-5020
  • Fax: 702-485-5083
Mailing address:
  • Phone: 702-485-5020
  • Fax: 702-485-5083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License NumberNV201708171149107
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License NumberNV201708171149107
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberNV201708171149107
License Number StateNV

VIII. Authorized Official

Name: VIRGINIA MAE KENDRID
Title or Position: CEO
Credential:
Phone: 702-506-7846