Provider Demographics
NPI:1073907549
Name:LILLICH, FRANK THOMAS II
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:THOMAS
Last Name:LILLICH
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3513 COLBY CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-4001
Mailing Address - Country:US
Mailing Address - Phone:702-370-5889
Mailing Address - Fax:
Practice Address - Street 1:3513 COLBY CREEK AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-4001
Practice Address - Country:US
Practice Address - Phone:702-370-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker