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General NPI Number Information
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NPI Number | 1194316380
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Entity Type | Organization
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Legal Business Name | ENDLESS EMPOWERMENT
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Dates
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Enumeration Date | 01/29/2021
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 3295 N FORT APACHE RD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89129-0209
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Country | US
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Telephone | 702-525-7037
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Fax |
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Provider Business Mailing Address
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Address Line | 1904 SIERRA HILLS WAY
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City | LAS VEGAS
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State | NV
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Zip | 89128-3181
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Country | US
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Telephone | 702-525-7037
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | TRACY YA-YIN KWAN
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Credential | LCSW
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Telephone | 702-525-7037
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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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