Provider Demographics
NPI:1235510827
Name:RAYS OF LIFE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:RAYS OF LIFE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEON
Authorized Official - Middle Name:DONNELL
Authorized Official - Last Name:SHAVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-710-3918
Mailing Address - Street 1:7390 W SAHARA AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2763
Mailing Address - Country:US
Mailing Address - Phone:702-435-5551
Mailing Address - Fax:
Practice Address - Street 1:7390 W SAHARA AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2763
Practice Address - Country:US
Practice Address - Phone:702-435-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health