Provider Demographics
NPI:1942672605
Name:MOJAVE ADULT, CHILD & FAMILY SERVICES
Entity Type:Organization
Organization Name:MOJAVE ADULT, CHILD & FAMILY SERVICES
Other - Org Name:ATOMIC PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-595-2186
Mailing Address - Street 1:PO BOX 571708
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89157-1708
Mailing Address - Country:US
Mailing Address - Phone:702-595-2186
Mailing Address - Fax:
Practice Address - Street 1:2975 S RAINBOW BLVD
Practice Address - Street 2:SUITE A, & C
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6242
Practice Address - Country:US
Practice Address - Phone:702-595-2186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty