Provider Demographics
NPI:1083869663
Name:RED ROCK GUIDANCE & WELLNESS CENTER
Entity Type:Organization
Organization Name:RED ROCK GUIDANCE & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-947-4749
Mailing Address - Street 1:2580 MONTESSOURI STREET
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3065
Mailing Address - Country:US
Mailing Address - Phone:702-947-4749
Mailing Address - Fax:702-256-2295
Practice Address - Street 1:2580 MONTESSOURI STREET
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3065
Practice Address - Country:US
Practice Address - Phone:702-947-4749
Practice Address - Fax:702-256-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0936251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health