Organization
GETAWAY ADVANCED SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY WILLIAMS (OWNER)
(702) 502-2504
Entity
Organization
Contact information
Practice address
3780 E FELIX BLVD, TUCSON, AZ 85706-1926
(470) 250-2250
Mailing address
6212 HARDGATE ST, NORTH LAS VEGAS, NV 89031-1392
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1401743907
DRIVER LICENSE NUMBER
—
Enumeration date
02/19/2019
Last updated
02/19/2019
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