Provider Demographics
NPI:1427349679
Name:LITTLE ANGELS YOUTH SERVICES
Entity type:Organization
Organization Name:LITTLE ANGELS YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/QMHA
Authorized Official - Prefix:
Authorized Official - First Name:JONI
Authorized Official - Middle Name:
Authorized Official - Last Name:STUMPF
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:702-577-5977
Mailing Address - Street 1:1060 PINCAY DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-2935
Mailing Address - Country:US
Mailing Address - Phone:702-577-5977
Mailing Address - Fax:702-476-4767
Practice Address - Street 1:1060 PINCAY DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-2935
Practice Address - Country:US
Practice Address - Phone:702-577-5977
Practice Address - Fax:702-476-4767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101YM0800X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty