MEDICARE: STRONG BEHAVIORAL HEALTH GROUP 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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1962054007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRONG BEHAVIORAL HEALTH GROUP LLC

Provider Business Mailing Address
First Line	:	7100 GRAND MONTECITO PKWY UNIT 4043
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-0279
Country	:	US
Telephone Number	:	702-581-8457
Fax Number	:

Provider Business Practice Location Address
First Line	:	7100 GRAND MONTECITO PKWY UNIT 4043
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-0279
Country	:	US
Telephone Number	:	702-581-8457
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JIMMIE BIZET STRONG
Credential	:
Telephone Number	:	702-581-8457

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	05/13/2021

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