Provider Demographics
NPI:1386180271
Name:MMM SERVICES LLC
Entity Type:Organization
Organization Name:MMM SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSR
Authorized Official - Phone:404-437-4157
Mailing Address - Street 1:720 E CHARLESTON BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-1559
Mailing Address - Country:US
Mailing Address - Phone:404-437-4157
Mailing Address - Fax:
Practice Address - Street 1:720 E CHARLESTON BLVD STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-1559
Practice Address - Country:US
Practice Address - Phone:404-437-4157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20171029694251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health