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General NPI Number Information
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NPI Number | 1790019131
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Entity Type | Organization
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Legal Business Name | LUTHERAN SOCIAL SERVICES OF NEVADA
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 73 SPECTRUM BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89101-4838
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Country | US
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Telephone | 702-639-1730
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Fax | 702-639-1736
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Provider Business Mailing Address
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Address Line | 73 SPECTRUM BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89101-4838
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Country | US
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Telephone | 702-639-1730
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Fax | 702-639-1736
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ARMENA MKHITARYAN
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Credential | MPA
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Telephone | 702-639-1730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 5948PCS-4
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NV
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