Organization
BRIDGE OF HOPE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND LEE LAVENDER (DIRECTOR OF CLIENT SERVICES)
(702) 209-7049
Entity
Organization
Contact information
Practice address
1736 E CHARLESTON BLVD, #46, LAS VEGAS, NV 89104-7900
(702) 209-7049
Mailing address
1736 E CHARLESTON BLVD, #46, LAS VEGAS, NV 89104-7900
(702) 209-7049
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902198559
NPI
NV
Enumeration date
01/26/2015
Last updated
01/26/2015
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