Provider Demographics
NPI:1427319094
Name:HEART OF A GIRL
Entity type:Organization
Organization Name:HEART OF A GIRL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TEMPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-871-3500
Mailing Address - Street 1:5626 W KATIE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2326
Mailing Address - Country:US
Mailing Address - Phone:702-871-3500
Mailing Address - Fax:
Practice Address - Street 1:5626 W KATIE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2326
Practice Address - Country:US
Practice Address - Phone:702-871-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEART OF A GIRL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-31
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services