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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELLA DAWKINS (OWNER)
(702) 743-5908
Entity
Organization

Contact information

Practice address
6132 PASSIONATE CT, N LAS VEGAS, NV 89031-3538
(702) 743-5908
Mailing address
6132 PASSIONATE CT, N LAS VEGAS, NV 89031-3538
(702) 743-5908

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NV20111510784
NV

Other

Enumeration date
02/11/2012
Last updated
02/11/2012
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