Phenomenal Angels
LBN: Kimberly Broussard
Phenomenal Angels is an health care organization with primary practice located at 3380 E Russell Rd Suite 104, Las Vegas NV 89120-3402. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Managed Care Organizations / Preferred Provider Organization. Managed Care Organizations / Preferred Provider Organization is the primary health care specialty.
Kimberly Broussard can be contacted via phone (702) 476-0448, or through Broussard, Kimberly Rashone via phone (702) 807-1718.
Contact Information
Primary practice address
3380 E Russell Rd Suite 104
Las Vegas NV 89120-3402
Phone: (702) 476-0448
Fax: (702) 476-0449
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | ||
| Managed Care Organizations / Preferred Provider Organization | 305R00000X |
Profile Details
| NPI number | 1477908275 |
|---|---|
| LBN Legal business name | Kimberly Broussard |
| DBA Doing business as | Phenomenal Angels |
| Authorized official | Broussard, Kimberly Rashone |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 28th, 2016 |
| Last updated | Apr 29th, 2016 - about 8 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
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