Organization · NPI-2

Applied Therapies And Wellness Of Nevada

Pediatrics, Developmental - Behavioral Pediatrics · Las Vegas, NV

NPI number1891219762
StatusActive
Last updated in NPPESAug 1, 2017

Details

NPI
1891219762
Entity type
Organization (NPI-2)
Legal business name
Applied Therapies And Wellness Of Nevada
Organization subpart
No
Enumeration date
Aug 1, 2017
Last updated
Aug 1, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080P0006X Pediatrics, Developmental - Behavioral Pediatrics––Yes
251E00000X Home Health––

Practice location

3802 Ruskin St
Las Vegas, NV 89147-1071

Phone 801-674-0015

Mailing address

2812 E Pamela Dr
Cottonwood Heights, UT 84121-5228

Authorized official

Andrew Fichialos
Owner/Ceo
8016740015

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