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General NPI Number Information
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NPI Number | 1992463517
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Entity Type | Organization
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Legal Business Name | SOUTHERN NEVADA FAMILY SERVICES LLC
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 6935 ALIANTE PKWY STE 104
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City | N LAS VEGAS
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State | NV
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Zip | 89084-5819
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Country | US
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Telephone | 702-273-9890
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Fax |
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Provider Business Mailing Address
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Address Line | 6935 ALIANTE PKWY STE 104
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City | N LAS VEGAS
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State | NV
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Zip | 89084-5819
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Country | US
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Telephone | 702-273-9890
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. JESSICA CARR
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Credential |
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Telephone | 702-273-9890
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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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