Provider Demographics
NPI:1275029803
Name:REDEEMER HEALTH SERVICES
Entity Type:Organization
Organization Name:REDEEMER HEALTH SERVICES
Other - Org Name:REDEEMER HEALTH SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:
Authorized Official - Last Name:UGBODU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-630-7273
Mailing Address - Street 1:624 BONANZA PLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-1806
Mailing Address - Country:US
Mailing Address - Phone:702-630-7273
Mailing Address - Fax:702-586-7334
Practice Address - Street 1:624 BONANZA PLAIN AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-1806
Practice Address - Country:US
Practice Address - Phone:702-630-7273
Practice Address - Fax:702-586-7334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty