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General NPI Number Information
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NPI Number | 1346661378
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Entity Type | Organization
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Legal Business Name | STILL STANDING,INC
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 03/31/2014
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Provider Practice Location Address
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Address Line | 800 N RAINBOW BLVD STE 130
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City | LAS VEGAS
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State | NV
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Zip | 89107-1190
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Country | US
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Telephone | 702-337-3799
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Fax | 702-921-3251
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Provider Business Mailing Address
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Address Line | 800 N RAINBOW BLVD STE 130
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City | LAS VEGAS
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State | NV
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Zip | 89107-1190
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Country | US
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Telephone | 702-337-3799
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Fax | 702-921-3251
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Authorized Official
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Title or Position | PRESIDENT
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Name | THAMANI GODBOLT
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Credential |
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Telephone | 702-586-8015
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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 | NV20131642507
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License Number State | NV
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