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Organization

BAMBOO SUNRISE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHIRLEY LIM HOLDEMAN (CHIEF EXECUTIVE OFFICER)
(702) 433-3038
Entity
Organization

Contact information

Practice address
98 E LAKE MEAD PKWY STE 201, HENDERSON, NV 89015-6443
(702) 433-3038
Mailing address
98 E LAKE MEAD PKWY STE 201, HENDERSON, NV 89015-6443
(702) 433-3038

Taxonomy

Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
103TR0400X
Rehabilitation Psychologist
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
163WP0808X
Psychiatric/Mental Health Registered Nurse
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
11/18/2011
Last updated
09/10/2021
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