Organization
THE SUPPORT NETWORK L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREENATA BACON (MANAGING MEMBER)
(310) 658-7486
Entity
Organization
Contact information
Practice address
453 FILAREE PL, HENDERSON, NV 89015-7539
(310) 658-7486
Mailing address
453 FILAREE PL, HENDERSON, NV 89015-7539
(310) 658-7486
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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