Organization
HOME OF POSSIBILITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORY RON BIENIEMY (CEO)
(619) 549-7044
Entity
Organization
Contact information
Practice address
400 S 4TH ST STE 500, LAS VEGAS, NV 89101-6207
(702) 793-4233
Mailing address
400 S 4TH ST STE 500, LAS VEGAS, NV 89101-6207
(702) 793-4233
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538499876
—
NV
Enumeration date
01/14/2016
Last updated
01/14/2016
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