Provider Demographics
NPI:1093085425
Name:BOUNTIFUL FAMILY SERVICES INC
Entity Type:Organization
Organization Name:BOUNTIFUL FAMILY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ULIBARRI
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:702-927-9271
Mailing Address - Street 1:1485 W WARM SPRINGS RD STE 107
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-7632
Mailing Address - Country:US
Mailing Address - Phone:702-547-0201
Mailing Address - Fax:702-944-7846
Practice Address - Street 1:1485 W WARM SPRINGS RD STE 107
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7632
Practice Address - Country:US
Practice Address - Phone:702-547-0201
Practice Address - Fax:702-944-7846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-02
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20111245989251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health