Provider Demographics
NPI:1538499876
Name:HOME OF POSSIBILITIES, LLC
Entity Type:Organization
Organization Name:HOME OF POSSIBILITIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O./OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:RON
Authorized Official - Last Name:BIENIEMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-570-5100
Mailing Address - Street 1:2700 EAST SUNSET ROAD
Mailing Address - Street 2:SUITE #40
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:702-570-5100
Mailing Address - Fax:702-570-5104
Practice Address - Street 1:2700 EAST SUNSET ROAD
Practice Address - Street 2:SUITE #40
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-570-5100
Practice Address - Fax:702-570-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV225400000X
NV251S00000X251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty