1851537195 NPI number — SOUTHERN NEVADA ADULT MENTAL HEALTH

Table of content: (NPI 1851537195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851537195 NPI number — SOUTHERN NEVADA ADULT MENTAL HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHERN NEVADA ADULT MENTAL HEALTH
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:
1851537195
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6161 W. CHARLESTON BLVD
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:
89146-1126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-486-6570
Provider Business Mailing Address Fax Number:
702-486-8330

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
720 S. 7TH STREET
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-668-4700
Provider Business Practice Location Address Fax Number:
702-668-4701
Provider Enumeration Date:
12/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
EBO
Authorized Official First Name:
EMMANUEL
Authorized Official Middle Name:
C
Authorized Official Title or Position:
STATEWIDE PHARMACY DIRECTOR
Authorized Official Telephone Number:
702-486-6570

Provider Taxonomy Codes

  • Taxonomy code: 283Q00000X , with the licence number:  PH02268 , 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)

  • Identifier: 2991063 . This is a "NABP#" identifier . This identifiers is of the category "OTHER".




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