Organization
KIDS TURF ACADEMY II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE LINNETTE HARRIS (DIRECTOR)
(702) 491-1265
Entity
Organization
Contact information
Practice address
1380 E SILVERADO RANCH BLVD, LAS VEGAS, NV 89183-5924
(702) 453-8877
(702) 453-8874
Mailing address
1380 E SILVERADO RANCH BLVD, LAS VEGAS, NV 89183-5924
(702) 453-8877
(702) 453-8874
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
20000108590101
NV
Other
Enumeration date
07/27/2009
Last updated
07/27/2009
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