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General NPI Number Information
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NPI Number | 1285175950
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Entity Type | Organization
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Legal Business Name | AFFINITY CHILD AND FAMILY SERVICES, INC
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 08/07/2018
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Provider Practice Location Address
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Address Line | 2030 E FLAMINGO RD STE 140
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City | LAS VEGAS
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State | NV
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Zip | 89119
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Country | US
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Telephone | 702-478-5527
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Fax | 702-478-6012
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Provider Business Mailing Address
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Address Line | 2030 E FLAMINGO RD STE 140
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City | LAS VEGAS
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State | NV
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Zip | 89119-0831
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Country | US
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Telephone | 702-478-5527
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Fax | 702-478-6012
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Authorized Official
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Title or Position | SECRETARY/OWNER
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Name | JOLLENE STILES-BRADSHER
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Credential | LCSW
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Telephone | 702-318-7544
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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 | NV20161529992
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License Number State | NV
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