Provider Demographics
NPI:1851745509
Name:INFINITY LIFE RESOURCE CENTERS
Entity Type:Organization
Organization Name:INFINITY LIFE RESOURCE CENTERS
Other - Org Name:INFINITY LRC
Other - Org Type:Other Name
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-747-0144
Mailing Address - Street 1:2150 N TENAYA WAY
Mailing Address - Street 2:1089
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0402
Mailing Address - Country:US
Mailing Address - Phone:702-747-0144
Mailing Address - Fax:
Practice Address - Street 1:2150 N TENAYA WAY
Practice Address - Street 2:1089
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0402
Practice Address - Country:US
Practice Address - Phone:702-747-0144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20161185819251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management