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General NPI Number Information
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NPI Number | 1417473927
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Entity Type | Organization
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Legal Business Name | OUR FAMILIES BEHAVIORAL HEALTH SERVICE LLC
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 08/16/2017
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Provider Practice Location Address
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Address Line | 810 S 7TH ST
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City | LAS VEGAS
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State | NV
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Zip | 89101-6910
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 4904 CAMINO AL NORTE 336206
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89033
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Country | US
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Telephone | 702-969-0558
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MONIQUE MASON
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Credential |
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Telephone | 702-969-0558
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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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