1649716176 NPI number — METROPOLITAN BEHAVIORAL HEALTH LLC

Table of content: GERMAN GABRIEL SANTANA DDS (NPI 1427630086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649716176 NPI number — METROPOLITAN BEHAVIORAL HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METROPOLITAN BEHAVIORAL HEALTH LLC
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:
1649716176
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 N RAINBOW BLVD STE 208
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:
89107-1193
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-354-0017
Provider Business Mailing Address Fax Number:
702-948-5001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 N RAINBOW BLVD STE 208
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:
89107-1193
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-354-0017
Provider Business Practice Location Address Fax Number:
702-948-5001
Provider Enumeration Date:
01/08/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ARSON
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
702-354-0017

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  NV20161739541 , 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)





Copyright © 2007-2026 www.npivalidator.com