Organization
THE VILLAGE BEHAVIOR HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY FULTON (CO OWNER)
(619) 206-0963
Entity
Organization
Contact information
Practice address
6330 MCLEOD DR, SUITE 4&5, LAS VEGAS, NV 89120-4430
(702) 437-0341
Mailing address
17127 W BERNARDO DR, UNIT 207, SAN DIEGO, CA 92127-1513
(619) 206-0963
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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