Provider Demographics
NPI:1619481199
Name:YOUR FAMILY BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:YOUR FAMILY BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-814-1915
Mailing Address - Street 1:2350 S JONES BLVD STE 101-4C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3103
Mailing Address - Country:US
Mailing Address - Phone:702-214-2150
Mailing Address - Fax:
Practice Address - Street 1:2350 S JONES BLVD STE 101-4C
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3103
Practice Address - Country:US
Practice Address - Phone:702-214-2150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-20
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health