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General NPI Number Information
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NPI Number | 1962900548
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Entity Type | Organization
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Legal Business Name | SILVER DOLPHIN BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 975 SEVEN HILLS DR APT 2227
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City | HENDERSON
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State | NV
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Zip | 89052-4322
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Country | US
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Telephone | 702-695-1572
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Fax |
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Provider Business Mailing Address
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Address Line | 975 SEVEN HILLS DR APT 2227
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City | HENDERSON
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State | NV
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Zip | 89052-4322
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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 | MR. VLADIMIR DZUGAS
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Credential |
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Telephone | 702-695-1572
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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 | NV20171770226
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License Number State | NV
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