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NPI Code Detail

MEDICARE: KL BROWN BEHAVIORAL HEALTH SERVICES LLC

MEDICARE: KL BROWN BEHAVIORAL HEALTH SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1265159354
Entity Type Code : Organization
Provider Name (Legal Business Name) : KL BROWN BEHAVIORAL HEALTH SERVICES LLC
Provider Business Mailing Address
First Line : 5920 FOREST CREEK RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-1746
Country : US
Telephone Number : 725-222-8744
Fax Number :
Provider Business Practice Location Address
First Line : 1834 E BASELINE RD STE 101
Second Line :
City : TEMPE
State : AZ
Zip : 85283-1508
Country : US
Telephone Number : 725-222-8744
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LALENA CASTRO
Credential :
Telephone Number : 702-379-3766
Provider Enumeration Date : 10/20/2022
Last Update Date : 10/20/2022

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