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General NPI Number Information
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NPI Number | 1770463697
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Entity Type | Organization
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Legal Business Name | GAY AND LESBIAN COMMUNITY CENTER OF SOUTHERN NEVADA INC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 401 S MARYLAND PKWY
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City | LAS VEGAS
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State | NV
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Zip | 89101-7206
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Country | US
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Telephone | 702-802-5410
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Fax | 702-476-9717
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Provider Business Mailing Address
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Address Line | 401 S MARYLAND PKWY
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City | LAS VEGAS
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State | NV
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Zip | 89101-7206
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Country | US
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Telephone | 702-802-5410
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Fax | 702-476-9717
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Authorized Official
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Title or Position | MS
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Name | MONA LISA PAULO
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Credential |
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Telephone | 702-802-5410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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