Provider Demographics
NPI:1336478510
Name:GIFTED FAMILY SERVICES, LLC.
Entity Type:Organization
Organization Name:GIFTED FAMILY SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-591-2664
Mailing Address - Street 1:825 HOLLOWBLUFF AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-1440
Mailing Address - Country:US
Mailing Address - Phone:702-591-2664
Mailing Address - Fax:702-586-9656
Practice Address - Street 1:825 HOLLOWBLUFF AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-1440
Practice Address - Country:US
Practice Address - Phone:702-591-2664
Practice Address - Fax:702-586-9656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health