Provider Demographics
NPI:1255630356
Name:DAUGHTERS OF ZION LLC
Entity type:Organization
Organization Name:DAUGHTERS OF ZION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GROUP HOME ADMISNITRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:WINETTE
Authorized Official - Last Name:SIGGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-327-2143
Mailing Address - Street 1:3008 SANDBAR CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-0289
Mailing Address - Country:US
Mailing Address - Phone:702-327-2143
Mailing Address - Fax:702-635-5463
Practice Address - Street 1:8444 BANDIT BLUFF AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89143-0289
Practice Address - Country:US
Practice Address - Phone:702-327-2143
Practice Address - Fax:702-635-5463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities