Provider Demographics
NPI:1477784684
Name:CITIZENEX, INC.
Entity Type:Organization
Organization Name:CITIZENEX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR, BOARD OF DIRECTORS
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FURR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-274-1890
Mailing Address - Street 1:PO BOX 750221
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89136-0221
Mailing Address - Country:US
Mailing Address - Phone:702-274-1890
Mailing Address - Fax:702-221-5686
Practice Address - Street 1:1805 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3933
Practice Address - Country:US
Practice Address - Phone:702-274-1890
Practice Address - Fax:702-221-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4857-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty