Organization
BRIDGE OF HOPE COUNSELING
Active
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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