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General NPI Number Information
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NPI Number | 1902623713
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Entity Type | Organization
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Legal Business Name | TVP BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 2480 E TOMPKINS AVE STE 201
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City | LAS VEGAS
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State | NV
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Zip | 89121-7394
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Country | US
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Telephone | 725-305-1192
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Fax | 248-294-1408
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Provider Business Mailing Address
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Address Line | 2480 E TOMPKINS AVE STE 201
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City | LAS VEGAS
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State | NV
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Zip | 89121-7394
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Country | US
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Telephone | 725-305-1192
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Fax | 877-418-8013
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Authorized Official
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Title or Position | MANAGER
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Name | SUSIE MIRELES
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Credential |
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Telephone | 702-630-5740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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