Organization
QUALITY INDEPENDENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
D-ANA LYNN HERNANDEZ (QUALIFIED BEHAVIORAL AID)
(702) 445-1360
Entity
Organization
Contact information
Practice address
10332 HORSEBACK RIDGE AVE, LAS VEGAS, NV 89144-6867
(702) 445-1360
Mailing address
10332 HORSEBACK RIDGE AVE, LAS VEGAS, NV 89144-6867
(702) 445-1360
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1602237074
—
NV
Enumeration date
10/29/2013
Last updated
10/29/2013
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