Provider Demographics
NPI:1184216970
Name:CITY OF LAS VEGAS
Entity Type:Organization
Organization Name:CITY OF LAS VEGAS
Other - Org Name:COURTYARD HOMELESS RESOURCE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CERVANTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-229-6906
Mailing Address - Street 1:495 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-6318
Mailing Address - Country:US
Mailing Address - Phone:702-229-6906
Mailing Address - Fax:
Practice Address - Street 1:314 FOREMASTER LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-1008
Practice Address - Country:US
Practice Address - Phone:702-229-2484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty