Provider Demographics
NPI:1508683533
Name:LADDER TREATMENT SERVICES MANAGEMENT LLC
Entity type:Organization
Organization Name:LADDER TREATMENT SERVICES MANAGEMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-385-4849
Mailing Address - Street 1:6905 VIA LOCANDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-0113
Mailing Address - Country:US
Mailing Address - Phone:916-385-4849
Mailing Address - Fax:
Practice Address - Street 1:3749 SUDBURY RD
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-8613
Practice Address - Country:US
Practice Address - Phone:916-304-2098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty