Organization
IGNITE TEEN TREATMENT, LLC
Active
Other names
Ignite Teen Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN BOND (CFO)
(570) 203-9222
Entity
Organization
Contact information
Practice address
3722 LONE MESA DR, LAS VEGAS, NV 89147
(310) 721-6447
Mailing address
512 NORTHAMPTON ST # 158, EDWARDSVILLE, PA 18704-4560
(570) 203-9222
(570) 203-9477
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
10/16/2017
Last updated
11/20/2023
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