Provider Demographics
NPI:1437384229
Name:SOUTHERN NEVADA CHILDREN FIRST
Entity Type:Organization
Organization Name:SOUTHERN NEVADA CHILDREN FIRST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EX DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:702-719-9773
Mailing Address - Street 1:9811 W CHARLESTON BLVD # 2-863
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7528
Mailing Address - Country:US
Mailing Address - Phone:702-719-9773
Mailing Address - Fax:702-897-2984
Practice Address - Street 1:1100 MERIDIAN BAY DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1625
Practice Address - Country:US
Practice Address - Phone:702-719-9773
Practice Address - Fax:702-897-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5139-S251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1063672681Medicaid