Organization
CULTURATION INC.
Active
Other names
The Teen Spot
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHETONYA FORDHAM (OWNER/PRESIDENT)
(702) 574-1857
Entity
Organization
Contact information
Practice address
4144 THOMAS PATRICK AVE, NORTH LAS VEGAS, NV 89032-8942
(702) 487-3095
(702) 647-3714
Mailing address
4144 THOMAS PATRICK AVE, NORTH LAS VEGAS, NV 89032-8942
(702) 487-3095
(702) 647-3714
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/10/2009
Last updated
07/10/2009
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