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General NPI Number Information
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NPI Number | 1114806486
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Entity Type | Organization
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Legal Business Name | ALBA BEHAVIORAL HEALTH PC
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 3375 S RAINBOW BLVD UNIT 80691
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City | LAS VEGAS
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State | NV
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Zip | 89180-8832
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Country | US
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Telephone | 907-232-5282
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Fax | 844-305-0320
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Provider Business Mailing Address
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Address Line | 3375 S RAINBOW BLVD UNIT 80691
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City | LAS VEGAS
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State | NV
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Zip | 89180-8832
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Country | US
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Telephone | 907-232-5282
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Fax | 844-305-0320
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Authorized Official
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Title or Position | TREASURER
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Name | DAMON WILSON
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Credential |
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Telephone | 856-535-7079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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