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General NPI Number Information
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NPI Number | 1417778788
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Entity Type | Organization
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Legal Business Name | OUR PRECIOUS DAUGHTER'S INC DBA IRISE FOUNDATION
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 3606 N RANCHO DR STE 144
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City | LAS VEGAS
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State | NV
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Zip | 89130-3196
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Country | US
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Telephone | 702-334-3425
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Fax |
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Provider Business Mailing Address
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Address Line | 6931 DENIO ISLAND ST
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-4029
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Country | US
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Telephone | 702-334-3425
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Fax |
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Authorized Official
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Title or Position | FOUNDER/EXECUTIVE DIRECTOR
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Name | MS. SHERRIE SMITH
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Credential |
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Telephone | 702-334-3425
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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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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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