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General NPI Number Information
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NPI Number | 1952176943
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Entity Type | Organization
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Legal Business Name | DE CORAZON COUNSELING LAS VEGAS LLC
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 2470 SAINT ROSE PKWY STE 302
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City | HENDERSON
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State | NV
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Zip | 89074-7776
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Country | US
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Telephone | 702-763-3589
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Fax |
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Provider Business Mailing Address
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Address Line | 105 BOYSENBERRY LN
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City | HENDERSON
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State | NV
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Zip | 89074-2443
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Country | US
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Telephone | 702-480-4762
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BLANCA TORRES
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Credential |
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Telephone | 702-480-4762
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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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