Healthcare Provider Details

I. General information

NPI: 1326413881
Provider Name (Legal Business Name): LONDON FAMILY AND CHILDREN'S SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2015
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 E RUSSELL RD
LAS VEGAS NV
89120-2426
US

IV. Provider business mailing address

2715 E RUSSELL RD
LAS VEGAS NV
89120-2426
US

V. Phone/Fax

Practice location:
  • Phone: 702-483-5919
  • Fax: 702-483-5546
Mailing address:
  • Phone: 702-483-5919
  • Fax: 702-483-5546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: ROY RAY
Title or Position: CEO
Credential:
Phone: 702-483-5919