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General NPI Number Information
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NPI Number | 1801307947
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Entity Type | Organization
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Legal Business Name | A PLACE OF HOPE BEHAVIORAL HEALTH SERVICES OF NEVADA
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 06/09/2018
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Provider Practice Location Address
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Address Line | 8631 ISLA VISTA VALLEY CT
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City | LAS VEGAS
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State | NV
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Zip | 89178
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Country | US
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Telephone | 702-787-6150
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Fax | 702-787-6150
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Provider Business Mailing Address
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Address Line | 8631 ISLA VISTA VALLEY CT
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City | LAS VEGAS
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State | NV
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Zip | 89178-7521
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Country | US
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Telephone | 702-787-6150
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Fax |
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Authorized Official
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Title or Position | CEO/ EXECUTIVE DIRECTOR
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Name | SHANTAY SARAH COLEMAN
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Credential |
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Telephone | 702-787-6150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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