Provider Demographics
NPI:1407418601
Name:JOSEPHS HOUSE LLC
Entity Type:Organization
Organization Name:JOSEPHS HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-372-4574
Mailing Address - Street 1:8600 W CHARLESTON BLVD UNIT 208
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5407
Mailing Address - Country:US
Mailing Address - Phone:702-372-4574
Mailing Address - Fax:
Practice Address - Street 1:8600 W CHARLESTON BLVD UNIT 208
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5407
Practice Address - Country:US
Practice Address - Phone:702-372-4574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities