Organization
TRANSFORMATION 360 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICE DELIA PETERSON (OWNER)
(702) 628-1223
Entity
Organization
Contact information
Practice address
2801 N RAINBOW BLVD APT 212, LAS VEGAS, NV 89108-4583
(702) 628-1223
Mailing address
2801 N RAINBOW BLVD APT 212, LAS VEGAS, NV 89108-4583
(702) 628-1223
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/17/2017
Last updated
07/21/2022
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