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General NPI Number Information
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NPI Number | 1255756334
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Entity Type | Organization
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Legal Business Name | BASIC SKILLS BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 02/26/2014
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Last Update Date | 02/26/2014
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Provider Practice Location Address
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Address Line | 1601 HEATHER OAKS WAY
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-5011
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Country | US
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Telephone | 702-217-1292
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 HEATHER OAKS WAY
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-5011
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Country | US
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Telephone | 702-217-1292
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. LAWANDA STEVENS
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Credential |
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Telephone | 702-217-1292
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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 | NV20141085404
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License Number State | NV
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