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General NPI Number Information
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NPI Number | 1821541822
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Entity Type | Organization
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Legal Business Name | A NEW SUNRISE
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 07/27/2016
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Provider Practice Location Address
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Address Line | 2009 SUMMER LILY AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89081-2686
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Country | US
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Telephone | 702-526-0066
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Fax |
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Provider Business Mailing Address
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Address Line | 2009 SUMMER LILY AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89081-2686
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Country | US
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Telephone | 702-526-0066
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TREVINO MOORE
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Credential |
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Telephone | 702-526-0066
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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 |
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License Number State |
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