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Organization

ALW BEHAVIOR SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDRIONNA L. WILLIAMS (CEO)
(702) 808-1261
Entity
Organization

Contact information

Practice address
3757 DUSKY FLYCATCHER ST, LAS VEGAS, NV 89122-3546
(702) 808-1261
Mailing address
3757 DUSKY FLYCATCHER ST, LAS VEGAS, NV 89122-3546
(702) 808-1261

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1669627121
NV
05
1811262488
NV
Enumeration date
09/11/2015
Last updated
09/11/2015
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