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General NPI Number Information
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NPI Number | 1770996282
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Entity Type | Organization
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Legal Business Name | FAMILY MATTERS
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 101 LESTER 978
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City | LOGANDALE
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State | NV
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Zip | 89021
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Country | US
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Telephone | 702-285-2790
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Fax |
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Provider Business Mailing Address
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Address Line | 101 LESTER AVENUE
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City | OVERTON
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State | NV
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Zip | 89040
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Country | US
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Telephone | 702-285-2790
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MS. LINDA ROSE DALE
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Credential |
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Telephone | 702-285-2790
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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 | NV 20141339839
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License Number State | NV
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