Provider Demographics
NPI:1699195032
Name:ABC OF SOUTHERN NEVADA
Entity Type:Organization
Organization Name:ABC OF SOUTHERN NEVADA
Other - Org Name:DIVERSIFIED FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESKEETS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-683-4191
Mailing Address - Street 1:865 N EASTERN AVE
Mailing Address - Street 2:# A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-2312
Mailing Address - Country:US
Mailing Address - Phone:702-431-0733
Mailing Address - Fax:702-431-0448
Practice Address - Street 1:865 N EASTERN AVE
Practice Address - Street 2:# A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-2312
Practice Address - Country:US
Practice Address - Phone:702-431-0733
Practice Address - Fax:702-431-0448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty