Bully Busters 702

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BULLY BUSTERS 702

Practice address

930 W Owens Ave
Las Vegas, NV 89106-2516

Phone

(702) 339-6418

NPI assigned

Jul 17, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keith Bowen

Title

Director

Phone

(702) 292-5023

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1619656717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 W OWENS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 W OWENS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062516",
            "telephone_number": "702-339-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULLY BUSTERS 702",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-292-5023"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Bullock
• Ruhiyyih Bullock
• Sharon Bullock
• Steven D'Lando Bullock
• Steven John Bullock
• Ashley M. Bulosan
• Gail Bulosan
• Rolando Bulosan
• Zenaida Bulosan
• Fatuma Fakaro Bultum

• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.