Organization
GREENVILLE YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GREEN (OWNER)
(702) 743-9391
Entity
Organization
Contact information
Practice address
9313 MOUNTAIN RANGE AVE, LAS VEGAS, NV 89129-7833
(702) 743-9391
Mailing address
9313 MOUNTAIN RANGE AVE, LAS VEGAS, NV 89129-7833
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005051907
—
NV
Enumeration date
03/11/2011
Last updated
07/12/2011
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