Organization
ETERNITY'S PATH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARITA EDWARDS (PRESIDENT)
(702) 540-8296
Entity
Organization
Contact information
Practice address
1345 N HOLLYWOOD BLVD, LAS VEGAS, NV 89110-2021
(702) 758-5961
Mailing address
5546 CAMINO AL NORTE # 2-333, NORTH LAS VEGAS, NV 89031-0805
(702) 540-8296
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
NV20131272872
NV
101YA0400X
Addiction (Substance Use Disorder) Counselor
NV20131272872
NV
103T00000X
Psychologist
NV20131272872
NV
104100000X
Social Worker
NV20131272872
NV
251S00000X
Community/Behavioral Health Agency
Primary
NV20131272872
NV
Other
Enumeration date
05/10/2013
Last updated
08/08/2013
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