Provider Demographics
NPI:1265913842
Name:DIRECT FOCUS COUNSELING GROUP
Entity type:Organization
Organization Name:DIRECT FOCUS COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-619-6755
Mailing Address - Street 1:2590 WINDMILL LN STE 515
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5502
Mailing Address - Country:US
Mailing Address - Phone:702-619-6755
Mailing Address - Fax:702-780-7257
Practice Address - Street 1:1107 ALDENWOOD AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-3699
Practice Address - Country:US
Practice Address - Phone:702-619-6755
Practice Address - Fax:702-780-7257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health