| A.c.t.i.v.e | |
|
5836 S Pecos Rd Building D Suite 101 Las Vegas NV 89120-3418 | |
| (702) 281-6560 | |
| Not Available |
| Full Name | A.c.t.i.v.e |
|---|---|
| Speciality | Foster Care Agency |
| Location | 5836 S Pecos Rd, Las Vegas, Nevada |
| Authorized Official Name and Position | Brandon Mukes (ASSISTANT DIRECTOR) |
| Authorized Official Contact | 7022816560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A.c.t.i.v.e 52 Prominent Bluff Ct Henderson NV 89002-3306 Ph: (702) 281-6560 | A.c.t.i.v.e 5836 S Pecos Rd Building D Suite 101 Las Vegas NV 89120-3418 Ph: (702) 281-6560 |
| NPI Number | 1891052627 |
|---|---|
| Provider Enumeration Date | 04/18/2012 |
| Last Update Date | 01/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891052627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | NV20121132212 (Nevada) | Secondary |
| 253J00000X | Foster Care Agency | NV20121132212 (Nevada) | Primary |
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