Change Agents Of Social Services LLC
Community/Behavioral Health in North Las Vegas, NV. Organization (NPI-2).
NPI number1780363044
StatusActive
Last updated in NPPESJul 13, 2023
Details
- NPI
- 1780363044
- Entity type
- Organization (NPI-2)
- Legal business name
- Change Agents Of Social Services LLC
- Organization subpart
- No
- Enumeration date
- Jul 13, 2023
- Certification date
- Jul 13, 2023
- Last updated
- Jul 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 363LC1500X | Nurse Practitioner, Community Health | – | – | |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
2709 Positive CtNorth Las Vegas, NV 89031-0947
Phone 702-305-0652
Mailing address
2709 Positive CtNorth Las Vegas, NV 89031-0947
Authorized official
Christopher Hannible
Chief Executive Officer
7023050652
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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