Provider Demographics
NPI:1144787813
Name:ADVERSITIES N TIME LLC
Entity Type:Organization
Organization Name:ADVERSITIES N TIME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-329-4991
Mailing Address - Street 1:5546 CAMINO AL NORTE # 2-304
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0805
Mailing Address - Country:US
Mailing Address - Phone:702-329-4991
Mailing Address - Fax:702-920-8849
Practice Address - Street 1:820 E CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-1512
Practice Address - Country:US
Practice Address - Phone:702-329-4991
Practice Address - Fax:702-920-8848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children