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NPI Code Detail

MEDICARE: TRIDENT BEHAVIORAL HEALTH LLC

MEDICARE: TRIDENT BEHAVIORAL HEALTH LLC
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1649990029
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRIDENT BEHAVIORAL HEALTH LLC
Provider Business Mailing Address
First Line : 9308 CANALINO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-0538
Country : US
Telephone Number : 702-533-7344
Fax Number :
Provider Business Practice Location Address
First Line : 9315 W SUNSET RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5012
Country : US
Telephone Number : 702-638-7705
Fax Number : 702-638-7706
Authorized Official
Title or Position : PROVIDER
Name : BELINDA ORDEN
Credential : APRN
Telephone Number : 702-533-7344
Provider Enumeration Date : 08/29/2022
Last Update Date : 02/19/2023

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Directions to “TRIDENT BEHAVIORAL HEALTH LLC ” Practice Location

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