Provider Demographics
NPI:1265856553
Name:ROUNDS CENTER,L.L.C.
Entity Type:Organization
Organization Name:ROUNDS CENTER,L.L.C.
Other - Org Name:COUNSELING COMMUNITY COLLABORATION AND EDUCATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/LLC EMPLOYEE/SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:THORNTON ROUNDS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:928-208-3613
Mailing Address - Street 1:1642 MCCULLOCH BLVD N
Mailing Address - Street 2:#185
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-0961
Mailing Address - Country:US
Mailing Address - Phone:928-208-3613
Mailing Address - Fax:928-854-1661
Practice Address - Street 1:1979 MCCULLOCH BLVD N
Practice Address - Street 2:STE. 202
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-0953
Practice Address - Country:US
Practice Address - Phone:928-208-3613
Practice Address - Fax:928-854-1661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health