Provider Demographics
NPI:1710513387
Name:COMMUNIDAD HISPANA COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:COMMUNIDAD HISPANA COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:VERNETTE
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:702-591-3055
Mailing Address - Street 1:3670 N RANCHO DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3192
Mailing Address - Country:US
Mailing Address - Phone:702-591-3055
Mailing Address - Fax:702-432-6464
Practice Address - Street 1:3670 N RANCHO DR STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3192
Practice Address - Country:US
Practice Address - Phone:702-591-3055
Practice Address - Fax:702-432-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health