Healthcare Provider Details

I. General information

NPI: 1972037091
Provider Name (Legal Business Name): MVP BEHAVIORAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2017
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N RAINBOW BLVD STE 100
LAS VEGAS NV
89107
US

IV. Provider business mailing address

800 N RAINBOW BLVD STE 100
LAS VEGAS NV
89107-1190
US

V. Phone/Fax

Practice location:
  • Phone: 702-948-5011
  • Fax:
Mailing address:
  • Phone: 702-948-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberNV20171240254
License Number StateNV

VIII. Authorized Official

Name: ADRIANNE RICHARDSON
Title or Position: OWNER
Credential:
Phone: 832-420-3628