Provider Demographics
NPI:1649418724
Name:SMART START
Entity Type:Organization
Organization Name:SMART START
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-375-2861
Mailing Address - Street 1:4160 S PECOS RD STE 18
Mailing Address - Street 2:SUITE18
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5027
Mailing Address - Country:US
Mailing Address - Phone:702-332-8466
Mailing Address - Fax:
Practice Address - Street 1:4160 S PECOS RD STE 18
Practice Address - Street 2:SUITE18
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5027
Practice Address - Country:US
Practice Address - Phone:702-332-8466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health