Provider Demographics
NPI:1578917498
Name:MOVIN 4-WARD L.L.C.
Entity Type:Organization
Organization Name:MOVIN 4-WARD L.L.C.
Other - Org Name:MOVING FORWARD BEHAVIORAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOENIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCQUEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-717-1071
Mailing Address - Street 1:390 KENSINGTON PALACE AVE
Mailing Address - Street 2:UNIT 102
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-5619
Mailing Address - Country:US
Mailing Address - Phone:702-717-1071
Mailing Address - Fax:
Practice Address - Street 1:390 KENSINGTON PALACE AVE
Practice Address - Street 2:UNIT 102
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-5619
Practice Address - Country:US
Practice Address - Phone:702-717-1071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-17
Last Update Date:2016-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty