Provider Demographics
NPI:1548548597
Name:BROOKS BEHAVIORAL HEALTH CENTER LLC
Entity type:Organization
Organization Name:BROOKS BEHAVIORAL HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:J A
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-882-9002
Mailing Address - Street 1:3550 W CHEYENNE AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-8212
Mailing Address - Country:US
Mailing Address - Phone:702-882-9002
Mailing Address - Fax:
Practice Address - Street 1:3550 W CHEYENNE AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8212
Practice Address - Country:US
Practice Address - Phone:702-882-9002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health