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NPI Code Detail

MEDICARE: SOUTHERN NEVADA ADULT MENTAL HEALTH

MEDICARE: SOUTHERN NEVADA ADULT MENTAL HEALTH
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
1283Q00000XPsychiatric Hospital
23336C0002XClinic PharmacyPH02110NV
3261QM0850XAdult Mental Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12052189OTHERPK

General Provider Information

NPI Number : 1891756920
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN NEVADA ADULT MENTAL HEALTH
Provider Business Mailing Address
First Line : 4150 TECHNOLOGY WAY
Second Line : STE:300
City : CARSON CITY
State : NV
Zip : 89706-2026
Country : US
Telephone Number : 775-684-4051
Fax Number :
Provider Business Practice Location Address
First Line : 6161 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1126
Country : US
Telephone Number : 702-486-6000
Fax Number : 702-486-8077
Authorized Official
Title or Position : RATES & COST CONTAINMENT MANAGER
Name : MARGARET MOE
Credential :
Telephone Number : 775-684-5990
Provider Enumeration Date : 03/29/2006
Last Update Date : 05/17/2022

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1568579076 — SOUTHER NEVADA ADULT MENTAL HEALTH
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1609945047 — MRS. NANCY LEAH CALDWELL LCSW
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Directions to “SOUTHERN NEVADA ADULT MENTAL HEALTH ” 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.

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