NPI 1194955096

Kids Turf Academy II, LLC

Organisation Exclusive Provider Organization Las Vegas, NV

Practice location

Address: 1380 E Silverado Ranch Blvd, Las Vegas, NV 89183-5924
Phone: (702) 453-8877
Fax: (702) 453-8874

Authorised official

Name: Connie Linnette Harris
Title: Director
Phone: (702) 491-1265

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 20000108590101 (NV)

Other Exclusive Provider Organization providers in Nevada →

Registry record

NPI: 1194955096
Entity type: Organization
NPI issued: 27 Jul 2009
Record last updated: 27 Jul 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.