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General NPI Number Information
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NPI Number | 1003180647
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Entity Type | Organization
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Legal Business Name | NEVADA STATE BEHAVIORAL HEALTH SERVICES L.L.C.
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 3450 E RUSSELL RD STE 105L
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City | LAS VEGAS
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State | NV
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Zip | 89120-2201
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Country | US
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Telephone | 702-714-1648
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 E RUSSELL RD STE 105L
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City | LAS VEGAS
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State | NV
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Zip | 89120-2201
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Country | US
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Telephone | 702-810-9226
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROBIN MASON
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Credential | MFT
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Telephone | 702-714-1648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | NV20121129117
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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