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Organization
INDEPENDENT CHOICES FOR SUCCESS COMMUNITY DEVELOPMENT CORPORATION
Active
Organization
INDEPENDENT CHOICES FOR SUCCESS COMMUNITY DEVELOPMENT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS JONES-JEFFERSON (PRESIDENT)
(702) 573-5812
Entity
Organization
Contact information
Practice address
320 PRINCESS AVE, N LAS VEGAS, NV 89030-3809
(702) 573-5812
Mailing address
320 PRINCESS AVE, N LAS VEGAS, NV 89030-3809
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
—
NULL
103TH0100X
Health Service Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
251300000X
Local Education Agency (LEA)
—
NULL
251B00000X
Case Management Agency
—
NULL
251V00000X
Voluntary or Charitable Agency
—
NULL
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
NULL
261QG0250X
Genetics Clinic/Center
—
NULL
261QH0100X
Health Service Clinic/Center
—
NULL
347C00000X
Private Vehicle
—
NULL
Other
Enumeration date
07/23/2010
Last updated
05/27/2011
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