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General NPI Number Information
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NPI Number | 1841825346
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Entity Type | Organization
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Legal Business Name | 702 POINT PLACE
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 12/28/2020
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Provider Practice Location Address
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Address Line | 9856 POPLAR POINT AVE
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City | LAS VEGAS
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State | NV
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Zip | 89178-6315
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Country | US
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Telephone | 702-328-4634
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Fax |
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Provider Business Mailing Address
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Address Line | 9856 POPLAR POINT AVE
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City | LAS VEGAS
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State | NV
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Zip | 89178-6315
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMBER SUAREZ
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Credential |
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Telephone | 702-328-4634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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