Organization
CCF HEALTH & BEHAVIORAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTWON TELLIS (OWNER)
(702) 285-4138
Entity
Organization
Contact information
Practice address
5109 ACKABURG CT, LAS VEGAS, NV 89130-2148
(702) 285-4138
Mailing address
5109 ACKABURG CT, LAS VEGAS, NV 89130-2148
(702) 285-4138
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/01/2017
Last updated
12/01/2017
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