Organization
SUPPORTIVE COMMUNITY SERVICES LLC
Active
Other names
Supportive Community Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NIESHA S. ALLEN (DIRECTOR)
(702) 526-4573
Entity
Organization
Contact information
Practice address
2432 W PEORIA AVE, PHOENIX, AZ 85029-4726
(702) 526-4573
(702) 202-1180
Mailing address
3454 WHITMAN FALLS DR, LAS VEGAS, NV 89129-6355
(702) 526-4573
(702) 202-1180
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720451672
—
NV
Enumeration date
01/08/2020
Last updated
01/08/2020
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