Organization
FAMILY AND CHILD TREATMENT (FACT)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNETTE ROQUE (SUBSTANCE ABUSE COUNSELOR)
(702) 258-5855
Entity
Organization
Contact information
Practice address
6431 W SAHARA AVE STE 200, LAS VEGAS, NV 89146-3064
(702) 258-5855
(702) 258-9767
Mailing address
6431 W SAHARA AVE STE 200, LAS VEGAS, NV 89146-3064
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
NV19841011323
NV
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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