Healthcare Provider Details

I. General information

NPI: 1356932008
Provider Name (Legal Business Name): CHELSEY'S HOME FOR PREGNANT TEENS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2021
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N MICHAEL WAY
LAS VEGAS NV
89108-4665
US

IV. Provider business mailing address

3333 N MICHAEL WAY
LAS VEGAS NV
89108-4665
US

V. Phone/Fax

Practice location:
  • Phone: 702-918-7602
  • Fax:
Mailing address:
  • Phone: 702-918-7602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: FAY WARREN
Title or Position: DIRECTOR
Credential:
Phone: 702-918-7602