Organization
360 MEDHP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAYZINE AYALA (MANAGING MEMBER)
(702) 980-9624
Entity
Organization
Contact information
Practice address
2110 E FLAMINGO RD STE 360, LAS VEGAS, NV 89119-5190
(702) 559-4751
Mailing address
2110 E FLAMINGO RD STE 360, LAS VEGAS, NV 89119-5190
(702) 559-4751
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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