Provider Demographics
NPI:1629758446
Name:THERE IS NO HERO IN HEROIN (TINHIH)
Entity Type:Organization
Organization Name:THERE IS NO HERO IN HEROIN (TINHIH)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WORTHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-445-7318
Mailing Address - Street 1:3316 PLAZA DEL PAZ
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4032
Mailing Address - Country:US
Mailing Address - Phone:702-460-9415
Mailing Address - Fax:
Practice Address - Street 1:900 LIBERACE AVE STE B202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-1274
Practice Address - Country:US
Practice Address - Phone:702-445-7318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THERE IS NO HERO IN HEROIN FOUNDATION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1467079343Medicaid
NV1336536929Medicaid
NV1295316412Medicaid