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Organization
TOWER BRIDGE DEVELOPMENTAL HEALTH CENTER
Active
Organization
TOWER BRIDGE DEVELOPMENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANA WICKERSHAM (OWNER)
(702) 513-8321
Entity
Organization
Contact information
Practice address
9484 S EASTERN AVE, SUITE 67, LAS VEGAS, NV 89123-3987
(702) 513-8321
Mailing address
9484 S EASTERN AVE, SUITE 67, LAS VEGAS, NV 89123-3987
(702) 513-8321
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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