Healthcare Provider Details

I. General information

NPI: 1457742975
Provider Name (Legal Business Name): NEVADA INTEGRATED BEHAVIORAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2015
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 E CHARLESTON BLVD STE 310
LAS VEGAS NV
89104-1902
US

IV. Provider business mailing address

1721 E CHARLESTON BLVD STE 310
LAS VEGAS NV
89104-1902
US

V. Phone/Fax

Practice location:
  • Phone: 702-685-0620
  • Fax: 702-685-9674
Mailing address:
  • Phone: 702-515-9680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License NumberNV20131553514
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNV20131553514
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberNV20131553514
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberNV20131553514
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberNV20131553514
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberNV20131553514
License Number StateNV
# 7
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberNV20131553514
License Number StateNV
# 8
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberNV20131553514
License Number StateNV
# 9
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberNV20131553514
License Number StateNV
# 10
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberNV20131553514
License Number StateNV
# 11
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNV20131553514
License Number StateNV
# 12
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberNV20131553514
License Number StateNV
# 13
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberNV20131553514
License Number StateNV
# 14
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberNV20131553514
License Number StateNV
# 15
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberNV20131553514
License Number StateNV

VIII. Authorized Official

Name: MR. FESTUS EBONKA
Title or Position: OWNER/PRESIDENT
Credential: NURSE PRACTITIONER
Phone: 702-515-9680