Provider Demographics
NPI:1942727870
Name:HENCO INCORPORATED L.L.C
Entity Type:Organization
Organization Name:HENCO INCORPORATED L.L.C
Other - Org Name:DREAM WORKS FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY-FUNCHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-540-9700
Mailing Address - Street 1:5120 HICKAM AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2607
Mailing Address - Country:US
Mailing Address - Phone:702-540-9700
Mailing Address - Fax:
Practice Address - Street 1:5120 HICKAM AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2607
Practice Address - Country:US
Practice Address - Phone:702-540-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20171532511101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV20171532511Medicaid