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General NPI Number Information
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NPI Number | 1790322196
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Entity Type | Organization
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Legal Business Name | FAMILY CENTERS OF NEVADA LLC
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Dates
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Enumeration Date | 12/04/2019
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 222 S RAINBOW BLVD STE 212
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City | LAS VEGAS
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State | NV
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Zip | 89145-5356
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Country | US
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Telephone | 702-277-5406
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Fax | 702-852-0607
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Provider Business Mailing Address
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Address Line | 6545 S FORT APACHE RD STE 135-133
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City | LAS VEGAS
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State | NV
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Zip | 89148-6752
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Country | US
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Telephone | 702-277-5406
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Fax |
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Authorized Official
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Title or Position | OWNER / CEO
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Name | KIYONNA COLE
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Credential |
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Telephone | 702-277-5406
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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 |
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License Number State |
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