MEDICARE: INNOVATION BEHAVIORAL HEALTH SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1366075574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATION BEHAVIORAL HEALTH SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	1065 E FLAMINGO RD APT 718
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-7453
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6655 W SAHARA AVE STE A208
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-2812
Country	:	US
Telephone Number	:	702-900-2784
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. SANDRA GRAY
Credential	:
Telephone Number	:	702-900-2784

Provider Enumeration Date	:	02/16/2020
Last Update Date	:	02/16/2020

Similar Medicare Providers

1851233985 — SOHYUN KELSO
Practice Location Address:

6655 W SAHARA AVE STE A206
LAS VEGAS, NV
89146-2812

Practice Phone: 702-202-3383
Practice Fax:

1073978896 — JENNY LUBICK MSW
Practice Location Address:

6655 W SAHARA AVE STE A212
LAS VEGAS, NV
89146-2812

Practice Phone: 702-826-2759
Practice Fax:

1275297434 — MS. JINETH ROJAS
Practice Location Address:

6655 W SAHARA AVE STE A208
LAS VEGAS, NV
89146-2812

Practice Phone: 702-900-2784
Practice Fax:

1831065333 — PATH ACUPUNCTURE & HERBAL MEDICINE
Practice Location Address:

6655 W SAHARA AVE STE A206
LAS VEGAS, NV
89146-2812

Practice Phone: 702-202-3383
Practice Fax:

1306707690 — LIXIU HUANG
Practice Location Address:

6655 W SAHARA AVE STE A206
LAS VEGAS, NV
89146-2812

Practice Phone: 702-202-3383
Practice Fax:

1992707806 — ELJEN MEDICAL HOSPITAL
Practice Location Address:

5538 DUNCAN DR
LAS VEGAS, NV
89130-2812

Practice Phone: 702-645-2606
Practice Fax: 702-645-1478

Directions to “INNOVATION BEHAVIORAL HEALTH SOLUTIONS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.