# PROJECT LIFE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538791660
- **Authorized official:** NICOLE PUCCI PHD, LCSW (CLINICAL DIRECTOR)
- **Authorized official phone:** (702) 608-0404

## Contact information

- **Practice address:** 1770 W HORIZON RIDGE PKWY STE 130, HENDERSON, NV 89012-5024
- **Practice address phone:** (702) 608-0404
- **Mailing address:** 1770 W HORIZON RIDGE PKWY STE 130, HENDERSON, NV 89012-5024
- **Mailing address phone:** (702) 608-0404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 02/06/2020
- **Last updated:** 02/06/2020