Organization
HEAVEN BOUND LIFESTYLE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GOODWIN (CEO)
(775) 219-5679
Entity
Organization
Contact information
Practice address
7551 YOUNG CIR, RENO, NV 89511-1337
(775) 219-5679
Mailing address
PO BOX 3527, SPARKS, NV 89432-3527
(775) 219-5679
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
NV
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005048283
—
NV
Enumeration date
05/10/2016
Last updated
05/10/2016
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