Organization
RUSH ORGANIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JACKSON LCSW (PROGRAM MANAGER)
(702) 586-6870
Entity
Organization
Contact information
Practice address
3013 N RANCHO DR, 128, LAS VEGAS, NV 89130-3345
(702) 338-8772
Mailing address
7432 REDBREAST CT, NORTH LAS VEGAS, NV 89084-2493
(702) 586-6870
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
5450-C
NV
251S00000X
Community/Behavioral Health Agency
Primary
5450-C
NV
Other
Enumeration date
02/15/2011
Last updated
05/08/2012
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