Provider Demographics
NPI:1790090181
Name:TEMPORARY ASSISTANCE FOR DOMESTIC CRISIS
Entity Type:Organization
Organization Name:TEMPORARY ASSISTANCE FOR DOMESTIC CRISIS
Other - Org Name:SAFENEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER / HR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:RUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-821-2722
Mailing Address - Street 1:3900 MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3123
Mailing Address - Country:US
Mailing Address - Phone:702-877-0133
Mailing Address - Fax:702-877-2772
Practice Address - Street 1:3900 MEADOWS LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3123
Practice Address - Country:US
Practice Address - Phone:702-877-0133
Practice Address - Fax:721-821-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0271106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty