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General NPI Number Information
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NPI Number | 1174847396
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Entity Type | Organization
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Legal Business Name | FAMILY INSTITUTE OF NEVADA
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 03/17/2010
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Provider Practice Location Address
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Address Line | 3663 E SUNSET RD SUITE 104
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City | LAS VEGAS
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State | NV
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Zip | 89120-3218
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Country | US
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Telephone | 702-794-0727
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Fax | 702-794-4501
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Provider Business Mailing Address
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Address Line | 3663 E SUNSET RD SUITE 104
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City | LAS VEGAS
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State | NV
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Zip | 89120-3218
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Country | US
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Telephone | 702-629-7024
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Fax | 702-794-4501
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD HERBERT HARRISON
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Credential | LMFT, M.DIV.
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Telephone | 702-629-7024
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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 | 0612
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License Number State | NV
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