MEDICARE: ARBOR BEHAVIORAL SERVICES 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
1	1041C0700X	Clinical Social Worker	6840-C	NV
2	251S00000X	Community/Behavioral Health Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1881089175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARBOR BEHAVIORAL SERVICES LLC

Provider Business Mailing Address
First Line	:	2575 MONTESSOURI ST STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3060
Country	:	US
Telephone Number	:	725-212-1347
Fax Number	:	725-212-1347

Provider Business Practice Location Address
First Line	:	2575 MONTESSOURI ST STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3060
Country	:	US
Telephone Number	:	725-212-1347
Fax Number	:	725-212-1347

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VIRGINIA M KENDRID
Credential	:
Telephone Number	:	725-212-1347

Provider Enumeration Date	:	04/02/2015
Last Update Date	:	03/12/2019

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