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General NPI Number Information
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NPI Number | 1861179186
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Entity Type | Organization
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Legal Business Name | EMBRACE THE JOURNEY LLC
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 6955 N DURANGO DR UNIT 1004
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City | LAS VEGAS
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State | NV
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Zip | 89149-4412
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Country | US
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Telephone | 702-530-2612
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Fax |
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Provider Business Mailing Address
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Address Line | 4117 MIDNIGHT CREST AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-3742
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Country | US
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Telephone | 702-530-2612
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. WANDA T WHITE
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Credential | CPC
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Telephone | 702-530-2612
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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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