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General NPI Number Information
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NPI Number | 1134836745
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Entity Type | Organization
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Legal Business Name | SIMPLE LIFE FAVOR
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Dates
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Enumeration Date | 11/02/2022
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 420 S JONES BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89107-2658
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Country | US
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Telephone | 702-810-9226
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Fax |
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Provider Business Mailing Address
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Address Line | 7250 S DURANGO DR STE 130
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City | LAS VEGAS
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State | NV
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Zip | 89113-2255
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Country | US
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Telephone | 28-109-2267
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROBIN RENEE MASON
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Credential | LMFT
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Telephone | 702-810-9226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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