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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CLIFFORD DESHAWN OSLEY (C.E.O)
(702) 906-1174
Entity
Organization

Contact information

Practice address
101 S RAINBOW BLVD STE 13, LAS VEGAS, NV 89145-5378
(702) 906-1174
(702) 910-2801
Mailing address
101 S RAINBOW BLVD STE 13, LAS VEGAS, NV 89145-5378
(702) 906-1174
(702) 910-2801

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
07/24/2014
Last updated
07/24/2014
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