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General NPI Number Information
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NPI Number | 1881200723
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Entity Type | Organization
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Legal Business Name | BAUZA NEUROPSYCHIATRY CENTER LLC
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 4268 ROANRIDGE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89120-2113
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Country | US
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Telephone | 702-810-0066
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Fax |
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Provider Business Mailing Address
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Address Line | 4268 ROANRIDGE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89120-2113
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Country | US
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Telephone | 702-810-0066
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Fax |
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Authorized Official
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Title or Position | OWNER-CEO
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Name | LUIS ANGEL RODRIGUEZ BAUZA
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Credential |
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Telephone | 702-810-0066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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