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General NPI Number Information
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NPI Number | 1568234185
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Entity Type | Organization
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Legal Business Name | LAS VEGAS PEACE CENTER LLC
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Dates
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Enumeration Date | 10/26/2023
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 1230 W OWENS AVE STE 6
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City | LAS VEGAS
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State | NV
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Zip | 89106-2451
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Country | US
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Telephone | 725-206-5333
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Fax |
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Provider Business Mailing Address
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Address Line | 1230 W OWENS AVE STE 6
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City | LAS VEGAS
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State | NV
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Zip | 89106-2451
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Country | US
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Telephone | 725-206-5333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TERONIA GILMORE
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Credential | MFT
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Telephone | 702-689-2547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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