Organization
ROCKINGHRANCH JDT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADETTE BASILIO (OWNER)
(702) 321-1677
Entity
Organization
Contact information
Practice address
14050 KYLE CANYON RD, LAS VEGAS, NV 89166-1338
(702) 301-5705
Mailing address
14050 KYLE CANYON RD, LAS VEGAS, NV 89166-1338
(702) 301-5705
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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