Organization
IGNITE TEEN TREATMENT, LLC
Active
Other names
Sahara OP
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA M POTTER (DIRECTOR OF COMPLIANCE)
(725) 272-0330
Entity
Organization
Contact information
Practice address
2330 PASEO DEL PRADO STE C103, LAS VEGAS, NV 89102-4336
(725) 272-0330
Mailing address
8635 W SAHARA AVE # 10, LAS VEGAS, NV 89117-5858
(725) 272-0330
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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