Provider Demographics
NPI:1821505736
Name:H.E.R.O.S UNITED LLC
Entity Type:Organization
Organization Name:H.E.R.O.S UNITED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEMAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-720-0904
Mailing Address - Street 1:10631 GIBBOUS MOON DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6493
Mailing Address - Country:US
Mailing Address - Phone:310-904-2899
Mailing Address - Fax:
Practice Address - Street 1:10631 GIBBOUS MOON DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6493
Practice Address - Country:US
Practice Address - Phone:310-904-2899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health