Provider Demographics
NPI:1902230535
Name:FAMILIES FIRST BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:FAMILIES FIRST BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:ADELE
Authorized Official - Last Name:SHELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-776-1132
Mailing Address - Street 1:3160 S VALLEY VIEW BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8316
Mailing Address - Country:US
Mailing Address - Phone:702-445-7611
Mailing Address - Fax:702-445-7918
Practice Address - Street 1:3160 S VALLEY VIEW BLVD STE 107
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8316
Practice Address - Country:US
Practice Address - Phone:702-445-7611
Practice Address - Fax:702-445-7918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1477826899Medicaid