Provider Demographics
NPI:1093361032
Name:ALDIS THERAPY SERVICES
Entity type:Organization
Organization Name:ALDIS THERAPY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPY SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDIS
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:702-401-1345
Mailing Address - Street 1:1311 TEMPO ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-6502
Mailing Address - Country:US
Mailing Address - Phone:702-401-1345
Mailing Address - Fax:
Practice Address - Street 1:2470 SAINT ROSE PKWY STE 302
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7776
Practice Address - Country:US
Practice Address - Phone:702-401-1345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1740832617Medicaid