Organization
BRIDGE OF HOPE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND LAVENDER (DIRECTOR OF CLIENT SERVICES)
(702) 464-5080
Entity
Organization
Contact information
Practice address
5258 S EASTERN AVE, 105, LAS VEGAS, NV 89119-2326
(702) 464-5080
Mailing address
5258 S EASTERN AVE, 105, LAS VEGAS, NV 89119-2326
(702) 464-5080
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NV20151113773
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902198559
—
NV
Enumeration date
03/04/2015
Last updated
08/18/2016
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