MEDICARE: OGIFI BEHAVIORAL HEALTH SERVICES INC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1679006878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OGIFI BEHAVIORAL HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	1504 JOHN BEVY CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-1382
Country	:	US
Telephone Number	:	170-227-5546
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 W CHEYENNE AVE STE 300
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-8223
Country	:	US
Telephone Number	:	702-275-5461
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ONAH EJINE NSOFOR
Credential	:
Telephone Number	:	702-275-5461

Provider Enumeration Date	:	04/05/2017
Last Update Date	:	06/21/2022

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