Organization
AH PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIAN TOLLIVER HAYWOOD (OWNER)
(702) 340-9456
Entity
Organization
Contact information
Practice address
4147 GLASS LANTERN DR, NORTH LAS VEGAS, NV 89032-3063
(702) 340-9456
Mailing address
4147 GLASS LANTERN DR, NORTH LAS VEGAS, NV 89032-3063
(702) 340-9456
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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