Organization
KAES CUBE OF LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNABELLE COOKS (OWNER)
(702) 204-2715
Entity
Organization
Contact information
Practice address
3909 S MARYLAND PKWY STE 305, LAS VEGAS, NV 89119-7520
(702) 701-8882
Mailing address
3909 S MARYLAND PKWY STE 305, LAS VEGAS, NV 89119-7520
(702) 701-8882
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/26/2017
Last updated
12/05/2018
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