Healthcare Provider Details

I. General information

NPI: 1275018566
Provider Name (Legal Business Name): ACCOMPLISHED ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 10/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2797 S MARYLAND PKWY STE 13
LAS VEGAS NV
89109-1576
US

IV. Provider business mailing address

2797 S MARYLAND PKWY STE 13
LAS VEGAS NV
89109-1576
US

V. Phone/Fax

Practice location:
  • Phone: 702-210-9896
  • Fax:
Mailing address:
  • Phone: 702-210-9896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: PHILIP A OJO
Title or Position: CEO
Credential:
Phone: 702-210-9896