Provider Demographics
NPI:1679917272
Name:THE CITY OF LAS VEGAS
Entity Type:Organization
Organization Name:THE CITY OF LAS VEGAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRNS WORKER/ ADAPTIVE RECREATION
Authorized Official - Prefix:
Authorized Official - First Name:AVION
Authorized Official - Middle Name:JAWAAN
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-417-9540
Mailing Address - Street 1:8604 APIARY WIND ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-2072
Mailing Address - Country:US
Mailing Address - Phone:702-417-9540
Mailing Address - Fax:
Practice Address - Street 1:6601 N BUFFALO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-4082
Practice Address - Country:US
Practice Address - Phone:702-604-6869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care