Organization
BRANDY NICOLE MCCULLOUCH
Active
Other names
Absolute Wellness Center LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY MCCULLOUCH (OWNER)
(702) 337-8991
Entity
Organization
Contact information
Practice address
708 COWBOY CROSS AVE, NORTH LAS VEGAS, NV 89081-6746
(702) 337-8991
Mailing address
708 COWBOY CROSS AVE, NORTH LAS VEGAS, NV 89081-6746
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851765416
—
NV
Enumeration date
12/17/2018
Last updated
12/17/2018
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