Basic Information
| Provider Information | |||||||||
| NPI: | 1235540311 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ELAINE J. HARPER | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ELAINE J HARPER | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1750 MARION DR APT 18B | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891153628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7025822291 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7465 W LAKE MEAD BLVD | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891281032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026589563 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2014 | ||||||||
| LastUpdateDate: | 05/12/2014 | ||||||||
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| AuthorizedOfficialLastName: | HARPER | ||||||||
| AuthorizedOfficialFirstName: | ELAINE | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7025822291 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.