Emancipation Health & Wellness LLC
Community/Behavioral Health in Las Vegas, NV. Organization (NPI-2).
NPI number1184122012
StatusActive
Last updated in NPPESJan 25, 2018
Details
- NPI
- 1184122012
- Entity type
- Organization (NPI-2)
- Legal business name
- Emancipation Health & Wellness LLC
- Organization subpart
- No
- Enumeration date
- Jan 25, 2018
- Last updated
- Jan 25, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | NV20181050463 | NV | Yes |
Practice location
222 S Rainbow Blvd Ste 111Las Vegas, NV 89145-5343
Phone 702-478-8205
Mailing address
222 S Rainbow Blvd Ste 111Las Vegas, NV 89145-5343
Phone 702-478-8205
Authorized official
Glen Tyrone Chambers
Owner
3107569965
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