Provider Demographics
NPI:1376990945
Name:HEALTHY OPTIONS COMMUNITY WELLNESS CENTER
Entity Type:Organization
Organization Name:HEALTHY OPTIONS COMMUNITY WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:TONEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:702-204-0150
Mailing Address - Street 1:6935 ALIANTE PKWY
Mailing Address - Street 2:NUM 104-169
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-5818
Mailing Address - Country:US
Mailing Address - Phone:702-204-0150
Mailing Address - Fax:702-586-8207
Practice Address - Street 1:6935 ALIANTE PKWY
Practice Address - Street 2:NUM 104-169
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-5818
Practice Address - Country:US
Practice Address - Phone:702-204-0150
Practice Address - Fax:702-586-8207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 251S00000X
NVMI0717106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty