Healthcare Provider Details

I. General information

NPI: 1265740989
Provider Name (Legal Business Name): DAO GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4443 SUN VISTA DR
LAS VEGAS NV
89104-5450
US

IV. Provider business mailing address

4262 BLUE DIAMOND RD. SUITE 102-297
LAS VEGAS NV
89139
US

V. Phone/Fax

Practice location:
  • Phone: 702-339-4593
  • Fax:
Mailing address:
  • Phone: 702-339-4593
  • Fax: 877-435-6030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. KIM VAN MARTIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 702-339-4593