Healthcare Provider Details

I. General information

NPI: 1376102251
Provider Name (Legal Business Name): HELP OF SOUTHERN NEVADA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3755 W LAKE MEAD BLVD
N LAS VEGAS NV
89032-4897
US

IV. Provider business mailing address

1640 E FLAMINGO RD
LAS VEGAS NV
89119-5249
US

V. Phone/Fax

Practice location:
  • Phone: 702-369-4357
  • Fax: 702-369-4089
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: PAIGE HOUSTON
Title or Position: BEHAVIOR HEALTH COMPLIANCE ANALYST
Credential:
Phone: 702-369-4357