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Organization
K.G. BEHAVIORAL SUPPORT SERVICES
Active
Organization
K.G. BEHAVIORAL SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRYSTAL T. GRIFFIN QMHA (OWNER)
(702) 592-8712
Entity
Organization
Contact information
Practice address
8871 W FLAMINGO RD, SUITE 202, LAS VEGAS, NV 89147-8757
(702) 592-8712
Mailing address
8871 W FLAMINGO RD, SUITE 202, LAS VEGAS, NV 89147-8757
(702) 592-8712
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
NULL
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
02/08/2012
Last updated
03/05/2012
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