Healthcare Provider Details

I. General information

NPI: 1225335888
Provider Name (Legal Business Name): R.U.S.H. ORGANIZATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6212 CAMINO DE ROSA
LAS VEGAS NV
89108
US

IV. Provider business mailing address

7745 AMBERWOOD PEAK COURT
LAS VEGAS NV
89166
US

V. Phone/Fax

Practice location:
  • Phone: 702-338-8772
  • Fax:
Mailing address:
  • Phone: 702-338-8772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN50008
License Number StateNV

VIII. Authorized Official

Name: RICHARD PATRICK HOLLIGAN
Title or Position: PRESIDENT/RN
Credential:
Phone: 702-338-8772