Provider Demographics
NPI:1841771409
Name:HOLDING ON HOPE COUNSELING CENTER
Entity Type:Organization
Organization Name:HOLDING ON HOPE COUNSELING CENTER
Other - Org Name:HOLDING ON HOPE COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRINCESS
Authorized Official - Middle Name:HARMONY
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-862-9831
Mailing Address - Street 1:6201 E LAKE MEAD BLVD UNIT 208
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-6995
Mailing Address - Country:US
Mailing Address - Phone:702-862-9831
Mailing Address - Fax:
Practice Address - Street 1:6201 E LAKE MEAD BLVD UNIT 208
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89156-6995
Practice Address - Country:US
Practice Address - Phone:702-862-9831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV=========Medicaid