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General NPI Number Information
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NPI Number | 1609524586
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Entity Type | Organization
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Legal Business Name | TRANSITIONS NEVADA LLC
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Dates
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Enumeration Date | 03/10/2022
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 2915 W CHARLESTON BLVD STE 125
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City | LAS VEGAS
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State | NV
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Zip | 89102-1939
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Country | US
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Telephone | 702-204-0150
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 MORNING MELODY CT
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City | HENDERSON
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State | NV
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Zip | 89011-3090
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Country | US
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Telephone | 702-204-0150
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. TONEY W STEPHENSON
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Credential | PSYD
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Telephone | 702-204-0150
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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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