Organization
SOLUTIONS SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYATTA WEATHERSBY (MANAGEMENT)
(909) 269-4906
Entity
Organization
Contact information
Practice address
3925 MARTIN LUTHER KING BLVD, STE 211, NORTH LAS VEGAS, NV 89032
(909) 269-4906
Mailing address
5747 MAGNOLIA AVE, RIALTO, CA 92377-3947
(909) 269-4906
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NV20171598675
NV
Other
Enumeration date
11/08/2017
Last updated
11/08/2017
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