Provider Demographics
NPI:1730434788
Name:NEVADA BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:NEVADA BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARVIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-351-1072
Mailing Address - Street 1:PO BOX 336390
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89033-6390
Mailing Address - Country:US
Mailing Address - Phone:702-207-6790
Mailing Address - Fax:702-207-6791
Practice Address - Street 1:2285 RENAISSANCE DR STE E
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6752
Practice Address - Country:US
Practice Address - Phone:702-207-6790
Practice Address - Fax:702-207-6791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20121430852251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health