Provider Demographics
NPI:1366045346
Name:FLT INTERVENTIONS
Entity Type:Organization
Organization Name:FLT INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERNAL
Authorized Official - Middle Name:LAURAINE
Authorized Official - Last Name:GLADSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MFTI
Authorized Official - Phone:702-931-7479
Mailing Address - Street 1:2928 VIGILANTE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6401
Mailing Address - Country:US
Mailing Address - Phone:702-931-7479
Mailing Address - Fax:
Practice Address - Street 1:2928 VIGILANTE CT
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-6401
Practice Address - Country:US
Practice Address - Phone:702-931-7479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty