Healthcare Provider Details

I. General information

NPI: 1437384229
Provider Name (Legal Business Name): SOUTHERN NEVADA CHILDREN FIRST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 MERIDIAN BAY DR
LAS VEGAS NV
89128-1625
US

IV. Provider business mailing address

9811 W CHARLESTON BLVD # 2-863
LAS VEGAS NV
89117-7528
US

V. Phone/Fax

Practice location:
  • Phone: 702-719-9773
  • Fax: 702-897-2984
Mailing address:
  • Phone: 702-719-9773
  • Fax: 702-897-2984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number5139-S
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number5139-S
License Number StateNV

VIII. Authorized Official

Name: MS. MONIQUE D HARRIS
Title or Position: EX DIRECTOR
Credential: MSW
Phone: 702-719-9773