Provider Demographics
NPI:1639478381
Name:THERAPEUTIC WELLNESS SERVICES, INC
Entity Type:Organization
Organization Name:THERAPEUTIC WELLNESS SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAELARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TILDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:702-273-7343
Mailing Address - Street 1:4915 ALTA DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3921
Mailing Address - Country:US
Mailing Address - Phone:702-273-7343
Mailing Address - Fax:702-553-3459
Practice Address - Street 1:4915 ALTA DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3921
Practice Address - Country:US
Practice Address - Phone:702-273-7343
Practice Address - Fax:702-553-3459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty