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General NPI Number Information
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NPI Number | 1831497239
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Entity Type | Organization
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Legal Business Name | THE SALVATION ARMY
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 03/26/2011
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Provider Practice Location Address
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Address Line | 35 W OWENS AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-6865
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Country | US
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Telephone | 702-639-0277
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Fax |
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Provider Business Mailing Address
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Address Line | 35 W OWENS AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-6865
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Country | US
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Telephone | 702-639-0277
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MAJOR MICHAEL F. OLSEN
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Credential |
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Telephone | 702-639-0277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4785-C
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License Number State | NV
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