# APPLE GROVE TREATMENT CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** APPLE GROVE FOSTER AGENCY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790063626
- **Authorized official:** MRS. ICIA SANDULAK (DIRECTOR)
- **Authorized official phone:** (702) 576-7942

## Contact information

- **Practice address:** 3155 E PATRICK LN, STE 1, LAS VEGAS, NV 89120-3481
- **Practice address phone:** (702) 992-0576
- **Practice address fax:** (702) 992-0391
- **Mailing address:** 3155 E PATRICK LN, STE 1, LAS VEGAS, NV 89120-3481
- **Mailing address phone:** (702) 992-0576
- **Mailing address fax:** (702) 992-0391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |
| 253J00000X | Foster Care Agency | — | NV | — |

## Other

- **Enumeration date:** 07/26/2011
- **Last updated:** 08/01/2024