Provider Demographics
NPI:1700190428
Name:KARLENE ULIBARRI, DBA, BOUNTIFUL FAMILY SERVICES
Entity Type:Organization
Organization Name:KARLENE ULIBARRI, DBA, BOUNTIFUL FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARLENE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ULIBARRI
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:702-927-9271
Mailing Address - Street 1:303 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-2822
Mailing Address - Country:US
Mailing Address - Phone:702-927-9271
Mailing Address - Fax:702-253-1969
Practice Address - Street 1:303 WYOMING ST
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-2822
Practice Address - Country:US
Practice Address - Phone:702-927-9271
Practice Address - Fax:702-253-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPSY 0498103T00000X
NV5114S253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253J00000XAgenciesFoster Care Agency
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty