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General NPI Number Information
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NPI Number | 1700371002
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Entity Type | Organization
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Legal Business Name | EMPOWERMENT CENTER OF SOUTHERN NEVADA LLC
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 1024 W OWENS AVE STE B
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City | LAS VEGAS
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State | NV
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Zip | 89106-2520
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Country | US
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Telephone | 702-636-8729
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Fax | 702-441-1808
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Provider Business Mailing Address
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Address Line | 1024 W OWENS AVE STE B
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City | LAS VEGAS
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State | NV
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Zip | 89106-2520
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Country | US
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Telephone | 702-636-8729
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Fax | 702-441-1808
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Authorized Official
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Title or Position | OWNER
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Name | JOHNA GAUFF
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Credential |
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Telephone | 702-721-8508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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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 | 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 #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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | NV20181464682
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License Number State | NV
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