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General NPI Number Information
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NPI Number | 1710360714
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Entity Type | Organization
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Legal Business Name | ATLAS COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 07/08/2015
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Last Update Date | 07/08/2015
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Provider Practice Location Address
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Address Line | 415 US HIGHWAY 95A S SUITE 702G
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City | FERNLEY
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State | NV
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Zip | 89408-9261
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Country | US
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Telephone | 775-575-2284
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Fax | 775-575-2384
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Provider Business Mailing Address
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Address Line | 415 US HIGHWAY 95A S SUITE 702G
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City | FERNLEY
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State | NV
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Zip | 89408-9261
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Country | US
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Telephone | 775-575-2284
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Fax | 775-575-2384
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. DINA PHIPPS
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Credential |
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Telephone | 17755752284
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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 | 20151405713
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License Number State | NV
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