1730508383 NPI number — HENDRIX INVESTMENT GROUP LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730508383 NPI number — HENDRIX INVESTMENT GROUP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HENDRIX INVESTMENT GROUP 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:
ABSOLUTE BEHAVIORAL HEALTH SERVICES
Provider Other Organization Name Type Code:
3
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:
1730508383
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6671 LAS VEGAS BLVD S
Provider Second Line Business Mailing Address:
BLDG D STE 210
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89119-3273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-389-5060
Provider Business Mailing Address Fax Number:
702-623-9254

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6671 LAS VEGAS BLVD S
Provider Second Line Business Practice Location Address:
BLDG D STE 210
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89119-3273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-389-5060
Provider Business Practice Location Address Fax Number:
702-623-9254
Provider Enumeration Date:
04/10/2014

Additional Information

Authorized Official

Authorized Official Last Name:
HENDRIX
Authorized Official First Name:
ALISHA
Authorized Official Middle Name:
N
Authorized Official Title or Position:
MANAGING MEMBER
Authorized Official Telephone Number:
702-389-5060

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  NV20121377667 , 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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