Provider Demographics
NPI:1891004883
Name:GOALS 4 SUCCESS
Entity Type:Organization
Organization Name:GOALS 4 SUCCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-940-9936
Mailing Address - Street 1:1700 E DESERT INN RD
Mailing Address - Street 2:SUITE 409
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-3242
Mailing Address - Country:US
Mailing Address - Phone:702-940-9936
Mailing Address - Fax:702-940-9936
Practice Address - Street 1:1700 E DESERT INN RD
Practice Address - Street 2:SUITE 409
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3242
Practice Address - Country:US
Practice Address - Phone:702-940-9936
Practice Address - Fax:702-940-9936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health