Basic Information
| Provider Information | |||||||||
| NPI: | 1356730436 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE M O V E PROJECT INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1058 W. OWENS | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027497444 | ||||||||
| FaxNumber: | 7027497844 | ||||||||
| Practice Location | |||||||||
| Address1: | 431 S 6TH ST | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891016915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027625633 | ||||||||
| FaxNumber: | 7027497844 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2015 | ||||||||
| LastUpdateDate: | 04/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | BANKS | ||||||||
| AuthorizedOfficialFirstName: | JOYCE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7027625433 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | NV20101125397 | NV | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 1720477755 | 05 | NV | MEDICAID |