Provider Demographics
NPI:1760155469
Name:FFLC, LLC
Entity Type:Organization
Organization Name:FFLC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:STOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-485-1310
Mailing Address - Street 1:4381 CHESSMAN WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-4639
Mailing Address - Country:US
Mailing Address - Phone:702-205-2511
Mailing Address - Fax:
Practice Address - Street 1:8390 W WINDMILL LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-4420
Practice Address - Country:US
Practice Address - Phone:702-485-1310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-28
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty