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Organization

LIFE INTERRUPTED TREATMENT, LLC

Active
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Organization

LIFE INTERRUPTED TREATMENT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ASHLEY NICOLE CAIN (OWNER)
(678) 857-6879
Entity
Organization

Contact information

Practice address
1910 FERRELL ST APT 10, LAS VEGAS, NV 89106-1254
(678) 857-6879
Mailing address
1910 FERRELL ST APT 10, LAS VEGAS, NV 89106-1254
(678) 857-6879

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
252Y00000X
Early Intervention Provider Agency
Primary
NV20161278438
NV
343900000X
Non-emergency Medical Transport (VAN)
2003291-048-122
NV
347C00000X
Private Vehicle
2105351319
NV

Other

Enumeration date
08/01/2016
Last updated
08/04/2016
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