Provider Demographics
NPI:1598205635
Name:CHANCES
Entity Type:Organization
Organization Name:CHANCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-702-7185
Mailing Address - Street 1:3531 E RUSSELL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2245
Mailing Address - Country:US
Mailing Address - Phone:602-702-7185
Mailing Address - Fax:702-478-5266
Practice Address - Street 1:3531 E RUSSELL RD
Practice Address - Street 2:SUITE A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2245
Practice Address - Country:US
Practice Address - Phone:602-702-7185
Practice Address - Fax:702-478-5266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty