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General NPI Number Information
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NPI Number | 1689587198
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Entity Type | Organization
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Legal Business Name | ROOTS & WINGS FAMILY FOUNDATION
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 2725 S JONES BLVD STE 106
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City | LAS VEGAS
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State | NV
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Zip | 89146-5605
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Country | US
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Telephone | 775-462-2140
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Fax |
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Provider Business Mailing Address
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Address Line | 11586 MONTE ISOLA ST
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City | LAS VEGAS
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State | NV
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Zip | 89141-3296
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Country | US
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Telephone | 775-462-2140
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Fax | 702-931-9862
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Authorized Official
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Title or Position | PRESIDENT
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Name | RATHENA DOBBS
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Credential |
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Telephone | 775-462-2140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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