Healthcare Provider Details

I. General information

NPI: 1023530623
Provider Name (Legal Business Name): FOUNDATION FOR POSITIVELY KIDS, A NONPROFIT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N PECOS RD BLDG M
LAS VEGAS NV
89101-2400
US

IV. Provider business mailing address

701 N PECOS RD BLDG M
LAS VEGAS NV
89101-2400
US

V. Phone/Fax

Practice location:
  • Phone: 702-262-0037
  • Fax: 702-476-9122
Mailing address:
  • Phone: 702-262-0037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: FRANCES MALINIS
Title or Position: COMPLIANCE DIRECTOR
Credential:
Phone: 702-410-7825