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General NPI Number Information
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NPI Number | 1851716302
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Entity Type | Organization
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Legal Business Name | LIFE SOLUTIONS OF NEVADA INC
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 3164 W. CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102
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Country | US
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Telephone | 336-926-6128
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Fax | 866-406-4630
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Provider Business Mailing Address
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Address Line | 8011 NORTH POINT BLVD SUTIE A
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City | WINSTON SALEM
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State | NC
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Zip | 27106
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Country | US
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Telephone | 336-926-6128
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Fax | 866-406-4630
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Authorized Official
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Title or Position | CEO
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Name | MR. ANDREW AUSTRAILA DINKINS
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Credential |
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Telephone | 336-926-6128
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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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