Provider Demographics
NPI:1386007847
Name:THE LAS VEGAS NEUROFEEDBACK DOCTORS
Entity Type:Organization
Organization Name:THE LAS VEGAS NEUROFEEDBACK DOCTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:POSSON
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:702-684-1455
Mailing Address - Street 1:222 S RAINBOW BLVD
Mailing Address - Street 2:STE 222
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-5340
Mailing Address - Country:US
Mailing Address - Phone:702-684-1455
Mailing Address - Fax:
Practice Address - Street 1:222 S RAINBOW BLVD
Practice Address - Street 2:STE 222
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5340
Practice Address - Country:US
Practice Address - Phone:702-684-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health