Organization
FOUNDATION OF CHANGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VITA JOHNSON (MANAGING MEMBER)
(702) 818-0847
Entity
Organization
Contact information
Practice address
912 E SAHARA AVE, LAS VEGAS, NV 89104-3004
(702) 818-0847
Mailing address
10120 W FLAMINGO RD # 4-198, LAS VEGAS, NV 89147-8392
(702) 818-0847
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/06/2014
Last updated
01/07/2014
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