Healthcare Provider Details

I. General information

NPI: 1396117412
Provider Name (Legal Business Name): SAGE HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2015
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8936 SPANISH RIDGE AVE
LAS VEGAS NV
89148-1354
US

IV. Provider business mailing address

PO BOX 82045
LAS VEGAS NV
89180-2045
US

V. Phone/Fax

Practice location:
  • Phone: 702-319-1555
  • Fax: 725-205-2895
Mailing address:
  • Phone: 702-319-1555
  • Fax: 725-205-2895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberC20110128-1214
License Number StateNV

VIII. Authorized Official

Name: JARED SHOEMAKER
Title or Position: COO
Credential: BS, MA
Phone: 702-319-1555