Provider Demographics
NPI:1003243478
Name:JOURNEY COMMUNITY HEALTH ORGANIZATION INC
Entity Type:Organization
Organization Name:JOURNEY COMMUNITY HEALTH ORGANIZATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:CPCI, LCADC-S
Authorized Official - Phone:702-817-3190
Mailing Address - Street 1:6512 N DECATUR BLVD
Mailing Address - Street 2:SUITE 130-114
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-1046
Mailing Address - Country:US
Mailing Address - Phone:702-830-2481
Mailing Address - Fax:702-664-0648
Practice Address - Street 1:6512 N DECATUR BLVD
Practice Address - Street 2:SUITE 130-114
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-1046
Practice Address - Country:US
Practice Address - Phone:702-830-2481
Practice Address - Fax:702-664-0648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health