Provider Demographics
NPI:1306182373
Name:H.O.P.E. LAS VEGAS
Entity Type:Organization
Organization Name:H.O.P.E. LAS VEGAS
Other - Org Name:H.O.P.E PAHRUMP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:QBA &QMHA
Authorized Official - Prefix:
Authorized Official - First Name:LECSY
Authorized Official - Middle Name:T
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-416-5312
Mailing Address - Street 1:2820 W CHARLESTON BLVD # C23
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1942
Mailing Address - Country:US
Mailing Address - Phone:702-437-4673
Mailing Address - Fax:
Practice Address - Street 1:2820 W CHARLESTON BLVD # C23
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1942
Practice Address - Country:US
Practice Address - Phone:702-437-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty