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General NPI Number Information
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NPI Number | 1407116866
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Entity Type | Organization
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Legal Business Name | INSPIRED HOPE MENTAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 05/19/2012
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 4005 PEPPER THORN AVE 201
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City | N LAS VEGAS
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State | NV
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Zip | 89081-3818
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Country | US
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Telephone | 702-203-6524
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Fax |
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Provider Business Mailing Address
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Address Line | 4005 PEPPER THORN AVE 201
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City | N LAS VEGAS
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State | NV
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Zip | 89081-3818
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Country | US
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Telephone | 702-203-6524
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | TERRENCE M BOOTH
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Credential |
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Telephone | 702-203-6524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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