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General NPI Number Information
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NPI Number | 1578377099
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Entity Type | Organization
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Legal Business Name | JOURNEY TO FAITH WELLNESS INC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 3050 N JONES BLVD APT 1118
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City | LAS VEGAS
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State | NV
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Zip | 89108-6556
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Country | US
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Telephone | 310-612-3778
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Fax |
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Provider Business Mailing Address
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Address Line | 3050 N JONES BLVD APT 1118
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City | LAS VEGAS
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State | NV
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Zip | 89108-6556
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JOHN JEFFERSON
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Credential |
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Telephone | 310-612-3778
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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