Radical Elevation
Community/Behavioral Health in Las Vegas, NV. Organization (NPI-2).
NPI number1164097556
StatusActive
Last updated in NPPESSep 23, 2024
Details
- NPI
- 1164097556
- Entity type
- Organization (NPI-2)
- Legal business name
- Radical Elevation
- Organization subpart
- No
- Enumeration date
- May 26, 2021
- Certification date
- Sep 23, 2024
- Last updated
- Sep 23, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
3551 E Bonanza Rd Ste 101Las Vegas, NV 89110-2198
Phone 702-482-7441
Mailing address
3551 E Bonanza Rd Ste 101Las Vegas, NV 89110-2198
Phone 702-482-7441
Authorized official
Brian Harge
Owner
7024232703
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