Provider Demographics
NPI:1437401296
Name:SOUTHERN NEVADA HOUSE OF HOPE MINISTRIES INC.
Entity Type:Organization
Organization Name:SOUTHERN NEVADA HOUSE OF HOPE MINISTRIES INC.
Other - Org Name:SOUTHERN NEVADA HOUSE OF HOPE TRANSITIONAL GROUP HOME SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LORENZO
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-399-1944
Mailing Address - Street 1:5221 RED GLORY DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-5389
Mailing Address - Country:US
Mailing Address - Phone:702-399-1944
Mailing Address - Fax:702-399-1944
Practice Address - Street 1:5221 RED GLORY DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-5389
Practice Address - Country:US
Practice Address - Phone:702-399-1944
Practice Address - Fax:702-399-1944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVC20120920-0754225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVC20120920-0754OtherCORPORATE CHARTER