Healthcare Provider Details

I. General information

NPI: 1366642084
Provider Name (Legal Business Name): COMMENCEMENTS: A NEW BEGINNING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6236 LUMBER RIVER CT
N LAS VEGAS NV
89081-6649
US

IV. Provider business mailing address

6236 LUMBER RIVER CT
N LAS VEGAS NV
89081-6649
US

V. Phone/Fax

Practice location:
  • Phone: 702-632-3446
  • Fax: 702-632-3446
Mailing address:
  • Phone: 702-632-3446
  • Fax: 702-632-3446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERELY ANN GRISBY
Title or Position: FOUNDER
Credential:
Phone: 702-632-3446