Organization
APPLE GROVE TREATMENT CENTER
Active
Other names
Apple Grove
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ICIA SANDULAK (MANAGING MEMBER)
(702) 576-7942
Entity
Organization
Contact information
Practice address
3155 E PATRICK LN STE 1, LAS VEGAS, NV 89120-3481
(702) 992-0576
(702) 992-0391
Mailing address
3155 E PATRICK LN STE 1, LAS VEGAS, NV 89120-3481
(702) 992-0576
(702) 992-0391
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
571237806
APPLE GROVE
—
Enumeration date
10/22/2019
Last updated
07/24/2024
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