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General NPI Number Information
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NPI Number | 1790035038
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Entity Type | Organization
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Legal Business Name | TRIUMPHANT LIFE CONNECTIONS LLC
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 8565 S EASTERN AVE STE 150
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City | LAS VEGAS
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State | NV
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Zip | 89123-2906
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Country | US
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Telephone | 702-551-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 10234 BEDROCK RIVER CT
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City | LAS VEGAS
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State | NV
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Zip | 89178-6514
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Country | US
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Telephone | 702-551-7700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. LINDA LAI
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Credential |
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Telephone | 702-551-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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