Fresh Start Vegas LLC
Community/Behavioral Health in Las Vegas, NV. Organization (NPI-2).
NPI number1669949566
StatusActive
Last updated in NPPESOct 29, 2018
Details
- NPI
- 1669949566
- Entity type
- Organization (NPI-2)
- Legal business name
- Fresh Start Vegas LLC
- Organization subpart
- No
- Enumeration date
- Oct 29, 2018
- Last updated
- Oct 29, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
400 S 4th St Ste 500Las Vegas, NV 89101-6207
Phone 702-849-0460 · Fax 702-920-7648
Mailing address
400 S 4th St Ste 500Las Vegas, NV 89101-6207
Phone 702-849-0460 · Fax 702-920-7648
Authorized official
Rossi Poole
Owner
7028490460
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