Healthcare Provider Details

I. General information

NPI: 1104696053
Provider Name (Legal Business Name): A TOUCH OF GRACE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2024
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5537 AYERS CLIFF ST
N LAS VEGAS NV
89081-2462
US

IV. Provider business mailing address

5537 AYERS CLIFF ST
N LAS VEGAS NV
89081-2462
US

V. Phone/Fax

Practice location:
  • Phone: 702-860-2234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TIARA BINGHAM
Title or Position: OWNER
Credential:
Phone: 702-860-2234