Bamboo Sunrise LLC
Community/Behavioral Health in Henderson, NV. Organization (NPI-2).
NPI number1942577994
StatusActive
Last updated in NPPESSep 10, 2021
Details
- NPI
- 1942577994
- Entity type
- Organization (NPI-2)
- Legal business name
- Bamboo Sunrise LLC
- Organization subpart
- No
- Enumeration date
- Nov 18, 2011
- Certification date
- Sep 10, 2021
- Last updated
- Sep 10, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 103TP2701X | Psychologist, Group Psychotherapy | – | – | |
| 103TR0400X | Psychologist, Rehabilitation | – | – | |
| 163WP0807X | Registered Nurse, Psych/Mental Health, Child & Adolescent | – | – | |
| 163WP0808X | Registered Nurse, Psych/Mental Health | – | – | |
| 163WP0809X | Registered Nurse, Psych/Mental Health, Adult | – | – |
Practice location
98 E Lake Mead Pkwy Ste 201Henderson, NV 89015-6443
Phone 702-433-3038
Mailing address
98 E Lake Mead Pkwy Ste 201Henderson, NV 89015-6443
Phone 702-433-3038
Authorized official
Shirley Lim Holdeman
Chief Executive Officer
7024333038
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