Healthcare Provider Details

I. General information

NPI: 1194383133
Provider Name (Legal Business Name): HOLDING HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 RENAISSANCE DR STE C
LAS VEGAS NV
89119
US

IV. Provider business mailing address

2255 RENAISSANCE DR STE C
LAS VEGAS NV
89119-6751
US

V. Phone/Fax

Practice location:
  • Phone: 702-901-4880
  • Fax: 702-434-3530
Mailing address:
  • Phone: 702-901-4880
  • Fax: 702-434-3530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER MILLER-HOOKS
Title or Position: OFFICE/ BILLING MANAGER
Credential:
Phone: 702-901-4880