Organization
THE PRINCE'S PASSION BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QUENESHIA TILLMAN (OWNER)
(702) 913-2708
Entity
Organization
Contact information
Practice address
5828 COLEMAN ST, NORTH LAS VEGAS, NV 89031-3820
(702) 502-8953
Mailing address
5828 COLEMAN ST, NORTH LAS VEGAS, NV 89031-3820
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NV20181129548
NV
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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