Provider Demographics
NPI:1376774877
Name:GIDDENS & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:GIDDENS & ASSOCIATES, LLC
Other - Org Name:UNITY VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:GIDDENS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSW, LSW
Authorized Official - Phone:702-501-6725
Mailing Address - Street 1:21 MARION DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-4666
Mailing Address - Country:US
Mailing Address - Phone:702-445-6594
Mailing Address - Fax:702-982-8712
Practice Address - Street 1:21 MARION DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-4666
Practice Address - Country:US
Practice Address - Phone:702-445-6594
Practice Address - Fax:702-982-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5095-C251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health