Organization
TRANSFORMATION 180
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICE DELIA HENRY (OWNER)
(562) 507-2966
Entity
Organization
Contact information
Practice address
1555 E FLAMINGO RD, 155, LAS VEGAS, NV 89119-5258
(702) 743-1999
Mailing address
6500 W CHARLESTON BLVD, 421, LAS VEGAS, NV 89146-9054
(702) 776-6541
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/11/2013
Last updated
10/11/2013
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