Healthcare Provider Details

I. General information

NPI: 1023929643
Provider Name (Legal Business Name): BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 SOUTH MARYLAND PARKWAY CARLSON EDUCATION BUILDING #226
LAS VEGAS NV
89154
US

IV. Provider business mailing address

4505 SOUTH MARYLAND PARKWAY CARLSON EDUCATION BUILDING #226; BOX 453033
LAS VEGAS NV
89154
US

V. Phone/Fax

Practice location:
  • Phone: 702-895-1532
  • Fax: 702-895-1530
Mailing address:
  • Phone: 702-895-0134
  • Fax: 702-895-1530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE G PAUL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 702-895-0134