Organization
FOUNDATIONS OF CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HENRIELLA DAVIS (OWNER)
(702) 991-3933
Entity
Organization
Contact information
Practice address
7468 EASINGWOLD DR, LAS VEGAS, NV 89113-3203
(702) 991-3933
Mailing address
2831 SAINT ROSE PKWY, SUITE 213, HENDERSON, NV 89052-4840
(702) 991-3933
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NV20101336776
NV
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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