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General NPI Number Information
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NPI Number | 1033632864
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Entity Type | Organization
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Legal Business Name | BNG CONSULTING LLC DBA ACADEMY OF HUMAN DEVELOPMENT
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Dates
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Enumeration Date | 07/24/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 235 N EASTERN AVE STE 109
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City | LAS VEGAS
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State | NV
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Zip | 89101-4544
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Country | US
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Telephone | 702-759-0050
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Fax | 702-759-0046
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Provider Business Mailing Address
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Address Line | 235 N EASTERN AVE STE 109
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City | LAS VEGAS
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State | NV
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Zip | 89101-4544
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Country | US
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Telephone | 702-759-0050
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Fax | 702-759-0046
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. ARCADIO BOLANOS X
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Credential |
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Telephone | 702-759-0050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | DUI000029477
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License Number State | NV
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