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NPI Code Detail

MEDICARE: NORTH LAS VEGAS BEHAVIORAL HEALTH

MEDICARE: NORTH LAS VEGAS 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
1261QA0600XAdult Day Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679068589
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH LAS VEGAS BEHAVIORAL HEALTH
Provider Business Mailing Address
First Line : 3131 W CRAIG RD STE 180
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-0861
Country : US
Telephone Number : 702-469-7897
Fax Number :
Provider Business Practice Location Address
First Line : 3277 W CRAIG RD STE 100-130
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-0792
Country : US
Telephone Number : 702-586-5999
Fax Number : 702-586-5991
Authorized Official
Title or Position : OWNER
Name : KIRK A WAN
Credential :
Telephone Number : 702-586-5999
Provider Enumeration Date : 06/25/2018
Last Update Date : 06/25/2018

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Directions to “NORTH LAS VEGAS BEHAVIORAL HEALTH ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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