Organization
P.R.I.D.E. SERVICES L.L.C.
Active
Other names
Life Changers Behavioral Health and Supportive Services, Life Changers
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA DENISE WALKER-DAVIS (MANAGER)
(702) 268-8109
Entity
Organization
Contact information
Practice address
1516 E TROPICANA AVE STE 154, LAS VEGAS, NV 89119-8316
(702) 268-8109
Mailing address
1516 E TROPICANA AVE STE 154, LAS VEGAS, NV 89119-8316
(702) 268-8109
(702) 268-8009
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
NV20141081108
NV
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407273360
—
NV
Enumeration date
03/27/2014
Last updated
03/05/2020
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