Provider Demographics
NPI:1801307947
Name:A PLACE OF HOPE BEHAVIORAL HEALTH SERVICES OF NEVADA
Entity type:Organization
Organization Name:A PLACE OF HOPE BEHAVIORAL HEALTH SERVICES OF NEVADA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANTAY
Authorized Official - Middle Name:SARAH
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-787-6150
Mailing Address - Street 1:8631 ISLA VISTA VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-7521
Mailing Address - Country:US
Mailing Address - Phone:702-787-6150
Mailing Address - Fax:
Practice Address - Street 1:8631 ISLA VISTA VALLEY CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178
Practice Address - Country:US
Practice Address - Phone:702-787-6150
Practice Address - Fax:702-787-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)