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Organization
IGNITE TEEN TREATMENT, LLC
Active
Organization
IGNITE TEEN TREATMENT, LLC
Active
Other names
Ignite Teen Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN BOND (CFO)
(570) 203-9222
Entity
Organization
Contact information
Practice address
3621 BAHAMA BAY CT, LAS VEGAS, NV 89147-6800
(310) 721-6447
Mailing address
512 NORTHAMPTON ST # 158, EDWARDSVILLE, PA 18704-4560
(570) 203-9222
(570) 203-9477
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
NULL
324500000X
Substance Abuse Rehabilitation Facility
—
NULL
Other
Enumeration date
12/28/2018
Last updated
11/20/2023
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