Provider Demographics
NPI:1851716302
Name:LIFE SOLUTIONS OF NEVADA INC
Entity Type:Organization
Organization Name:LIFE SOLUTIONS OF NEVADA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:AUSTRAILA
Authorized Official - Last Name:DINKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-926-6128
Mailing Address - Street 1:8011 NORTH POINT BLVD SUTIE A
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106
Mailing Address - Country:US
Mailing Address - Phone:336-926-6128
Mailing Address - Fax:866-406-4630
Practice Address - Street 1:3164 W. CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:336-926-6128
Practice Address - Fax:866-406-4630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health