Provider Demographics
NPI:1962961383
Name:AID FOR AIDS OF NEVADA
Entity type:Organization
Organization Name:AID FOR AIDS OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHADID
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:702-383-8095
Mailing Address - Street 1:1830 E SAHARA AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3739
Mailing Address - Country:US
Mailing Address - Phone:702-382-2326
Mailing Address - Fax:702-366-1609
Practice Address - Street 1:1830 E SAHARA AVE STE 210
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3739
Practice Address - Country:US
Practice Address - Phone:702-382-2326
Practice Address - Fax:702-366-1609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)