Organization
EAGLE QUEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY TIPPETTS (DIRECTOR)
(702) 376-0612
Entity
Organization
Contact information
Practice address
3680 N RANCHO DR, LAS VEGAS, NV 89130-3180
(702) 646-5437
(702) 228-8248
Mailing address
3680 N RANCHO DR, LAS VEGAS, NV 89130-3180
(702) 646-5437
(702) 228-8248
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
225400000X
Rehabilitation Practitioner
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
Other
Enumeration date
10/29/2010
Last updated
01/19/2021
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