Provider Demographics
NPI:1992050793
Name:ACCEPTANCE WELLNESS CENTER LLC
Entity type:Organization
Organization Name:ACCEPTANCE WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:702-241-7492
Mailing Address - Street 1:837 HOLLY LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-8290
Mailing Address - Country:US
Mailing Address - Phone:702-241-7492
Mailing Address - Fax:
Practice Address - Street 1:837 HOLLY LAKE WAY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-8290
Practice Address - Country:US
Practice Address - Phone:702-241-7492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health