Provider Demographics
NPI:1417778788
Name:OUR PRECIOUS DAUGHTER'S INC DBA IRISE FOUNDATION
Entity type:Organization
Organization Name:OUR PRECIOUS DAUGHTER'S INC DBA IRISE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-334-3425
Mailing Address - Street 1:6931 DENIO ISLAND ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-4029
Mailing Address - Country:US
Mailing Address - Phone:702-334-3425
Mailing Address - Fax:
Practice Address - Street 1:3606 N RANCHO DR STE 144
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3196
Practice Address - Country:US
Practice Address - Phone:702-334-3425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OUR PRECIOUS DAUGHTER'S INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health