Provident Place

NPI #1760049621 in N Las Vegas, Nevada

Provider Information

NPI Number: 1760049621
Entity Type: Organization
Organization Name: Provident Place
Primary Specialty: Behavior Analyst
Enumeration Date: May 24, 2019
Last Updated: May 24, 2019

Practice Location

Address: 611 SENECA RIDGE AVE
City: N Las Vegas
State: Nevada
ZIP Code: 89084-1315
Phone: (702) 561-3408

Authorized Official

Name: KATIE SMITH
Title: OWNER
Phone: (702) 561-3408

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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