Provider Demographics
NPI:1447596150
Name:A NEW GENERATION LIFE SKILLS
Entity Type:Organization
Organization Name:A NEW GENERATION LIFE SKILLS
Other - Org Name:A NEW GENERATION INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:INGUANZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-217-7683
Mailing Address - Street 1:8225 W SAHARA AVE STE H
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8929
Mailing Address - Country:US
Mailing Address - Phone:702-476-2899
Mailing Address - Fax:702-476-1575
Practice Address - Street 1:8225 W SAHARA AVE STE H
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8929
Practice Address - Country:US
Practice Address - Phone:702-476-2899
Practice Address - Fax:702-476-1575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20101749146251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1447596150Medicaid