Healthcare Provider Details

I. General information

NPI: 1699219915
Provider Name (Legal Business Name): ZURI BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 N WALNUT RD APT 221
LAS VEGAS NV
89115-6409
US

IV. Provider business mailing address

1950 N WALNUT RD APT 221
LAS VEGAS NV
89115-6409
US

V. Phone/Fax

Practice location:
  • Phone: 702-409-0356
  • Fax:
Mailing address:
  • Phone: 702-409-0356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: JEANNI COE
Title or Position: CEO
Credential:
Phone: 702-409-0356