Provider Demographics
NPI:1255682803
Name:KATHERINE GRISWOLD STANTON
Entity Type:Organization
Organization Name:KATHERINE GRISWOLD STANTON
Other - Org Name:SMART CHOICES BEHAVIORAL MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRISWOLD-STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-328-3618
Mailing Address - Street 1:9847 MOUNT MADERA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-7518
Mailing Address - Country:US
Mailing Address - Phone:702-328-3618
Mailing Address - Fax:
Practice Address - Street 1:9847 MOUNT MADERA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-7518
Practice Address - Country:US
Practice Address - Phone:702-328-3618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-23
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health