Provider Demographics
NPI:1851116909
Name:ELITE COUNSELING CENTER LLC
Entity type:Organization
Organization Name:ELITE COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:OFELIA
Authorized Official - Last Name:ECHEVARRIA DE DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-356-2986
Mailing Address - Street 1:4580 S EASTERN AVE STE 32
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6100
Mailing Address - Country:US
Mailing Address - Phone:702-356-2986
Mailing Address - Fax:
Practice Address - Street 1:4580 S EASTERN AVE STE 32
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6100
Practice Address - Country:US
Practice Address - Phone:702-356-2986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)