Organization
READY FOR CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDRE HARRIS (OWNER)
18778657481
Entity
Organization
Contact information
Practice address
1210 LEWIS ST, PAHRUMP, NV 89048-7874
(187) 786-5748
Mailing address
1210 LEWIS ST, PAHRUMP, NV 89048-7874
(187) 786-5748
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NV20101124834
NV
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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