Provider Demographics
NPI:1114532397
Name:UNIQUE TRANSFORMATIONS TREATMENT SERVICES
Entity Type:Organization
Organization Name:UNIQUE TRANSFORMATIONS TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-334-3425
Mailing Address - Street 1:3900 DALECREST DR APT 2037
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-1751
Mailing Address - Country:US
Mailing Address - Phone:702-334-3425
Mailing Address - Fax:
Practice Address - Street 1:7380 W SAHARA AVE STE 180
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2762
Practice Address - Country:US
Practice Address - Phone:702-334-3425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty