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General NPI Number Information
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NPI Number | 1174381107
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Entity Type | Organization
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Legal Business Name | REBOOT INVESTMENTS LLC
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Dates
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Enumeration Date | 03/13/2024
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 10601 CLARENCE DR STE 250
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City | FRISCO
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State | TX
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Zip | 75033-3867
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Country | US
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Telephone | 800-997-6977
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Fax | 661-489-0573
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Provider Business Mailing Address
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Address Line | 1241 PHYLLIS RAE CT
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City | NIPOMO
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State | CA
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Zip | 93444-8707
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Country | US
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Telephone | 310-272-0811
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Fax | 661-489-0573
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. DENNIS SCOTT FARMER
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Credential |
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Telephone | 310-272-0811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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