Organization
GALLUS DETOX LAS VEGAS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGINA CARROLL RN (DIRECTOR OF CLINICAL OPERATIONS)
(928) 533-0872
Entity
Organization
Contact information
Practice address
1550 W CRAIG RD STE 310, NORTH LAS VEGAS, NV 89032-0327
(928) 533-0872
(866) 565-8393
Mailing address
300 S JACKSON ST STE 220, DENVER, CO 80209-3134
(928) 533-0872
(866) 565-8393
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
01/03/2023
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