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General NPI Number Information
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NPI Number | 1265703441
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Entity Type | Organization
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Legal Business Name | PERSON-HOLISTIC INNOVATIONS (PHI), LLC
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 7041 SUNHAMPTON AVE UNIT 102
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City | LAS VEGAS
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State | NV
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Zip | 89129-1735
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Country | US
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Telephone | 702-518-4532
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35586
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City | LAS VEGAS
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State | NV
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Zip | 89133-5586
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Country | US
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Telephone | 702-518-4532
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST, CEO
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Name | MR. DANIEL ALLEN BERARDUCCI
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Credential | CPC, ACS
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Telephone | 814-397-6793
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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 | NV20111369130
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License Number State | NV
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