Provider Demographics
NPI:1760883342
Name:HELP OF SOUTHERN NEVADA
Entity Type:Organization
Organization Name:HELP OF SOUTHERN NEVADA
Other - Org Name:SHANNON WEST HOMELESS YOUTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-369-4357
Mailing Address - Street 1:1640 E FLAMINGO RD
Mailing Address - Street 2:#100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5249
Mailing Address - Country:US
Mailing Address - Phone:702-369-4357
Mailing Address - Fax:702-369-4089
Practice Address - Street 1:314 FOREMASTER LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-1008
Practice Address - Country:US
Practice Address - Phone:702-385-3776
Practice Address - Fax:702-836-2154
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HELP OF SOUTHERN NEVADA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management