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NPI Code Detail

MEDICARE: TRIUMPH BEHAVIORAL HEALTH

MEDICARE: TRIUMPH BEHAVIORAL HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyNV20016NV
2251S00000XCommunity/Behavioral Health AgencyNV

General Provider Information

NPI Number : 1376058719
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRIUMPH BEHAVIORAL HEALTH
Provider Business Mailing Address
First Line : 4520 S PECOS RD STE 3A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5937
Country : US
Telephone Number : 702-850-1250
Fax Number :
Provider Business Practice Location Address
First Line : 4520 S PECOS RD STE 3A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5937
Country : US
Telephone Number : 702-850-1250
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ROBERT E CLEMONS SR.
Credential :
Telephone Number : 702-708-0245
Provider Enumeration Date : 12/07/2017
Last Update Date : 12/07/2017

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Directions to “TRIUMPH BEHAVIORAL HEALTH ” Practice Location

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