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General NPI Number Information
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NPI Number | 1770095903
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Entity Type | Organization
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Legal Business Name | SUPERIOR CONNECTIONS SERVICES LLC
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Dates
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Enumeration Date | 10/27/2017
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Last Update Date | 10/27/2017
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Provider Practice Location Address
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Address Line | 1331 S RAINBOW BLVD STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89146-9080
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Country | US
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Telephone | 702-427-4537
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Fax |
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Provider Business Mailing Address
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Address Line | 4220 GLOBE ST
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-0746
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Country | US
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Telephone | 702-427-4537
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Fax |
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Authorized Official
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Title or Position | CEO/CO OWNER
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Name | MS. EBONY C GRANADOS
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Credential | MSW
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Telephone | 702-427-4537
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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 | NV20171693289
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License Number State | NV
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