1144582131 NPI number — UNITY VILLAGE BEHAVIORAL HEALTH CENTER

Table of content: MRS. CATHERINE MARY HEEB RN (NPI 1316278138)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144582131 NPI number — UNITY VILLAGE BEHAVIORAL HEALTH CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITY VILLAGE BEHAVIORAL HEALTH CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144582131
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3320 SUNRISE AVE STE 111
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89101-4853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-445-6594
Provider Business Mailing Address Fax Number:
702-445-6970

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3320 SUNRISE AVE STE 111
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89101-4853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-445-6594
Provider Business Practice Location Address Fax Number:
702-445-6970
Provider Enumeration Date:
06/14/2012

Additional Information

Authorized Official

Authorized Official Last Name:
GIDDENS
Authorized Official First Name:
RAYMOND
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
702-445-6594

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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