RAY TRAVIS GOODIN (NPI# 1023566023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023566023 |
| Entity Type | Individual |
| Full Name | RAY TRAVIS GOODIN |
| Practice Address |
2625 Wyandotte St # 17 Las Vegas NV 89102-6471 |
| Practice Telephone | 3134337330 |
| Mailing Telephone | 3134337330 |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2016-10-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
2625 WYANDOTTE ST # 17 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89102-6471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998397 | Natasha Moore | Technician | 3210 W Charleston Suite 2, Las Vegas, NV 89102 | 2020-10-07 |
| 1568077113 | Zulma Yaneth Tervizo Lopez | Technician | 455 W Oakey Blvd, Ste 111, Las Vegas, NV 89102 | 2020-09-10 |
| 1922629765 | Bianca Vaudreuil | Religious Nonmedical Practitioner | 3210 W Charleston Ste 2, Las Vegas, NV 89102 | 2020-05-04 |
| 1720608052 | Angelica Gutierrez | Technician | Vegas Compassionate Care ; 2820 W. Charleston Blvd B-21, Las Vegas, NV 89102 | 2020-04-16 |
| 1396370680 | Juana Maria Hernandez | Technician | 2881 S. Valley View Blvd, Suite #6, Las Vegas, NV 89102 | 2020-03-06 |
| 1609409648 | Janie Washington | Technician | 3210 W Charleston Blvd. Suite 2, Las Vegas, NV 89102 | 2020-02-18 |
| 1447893185 | Maria Josefina Castaneda | Technician | 2881 S. Valley View Blvd Suite #6, Los Vegas, NV 89102 | 2019-10-25 |
| 1427608777 | Virginia Hernandez Tolentino | Technician | 4550 W Oakley Blvd, Suite 101 A, Las Vegas, NV 89102 | 2019-09-18 |
| 1972153872 | Gladiola Cardoza Quinones | Technician | 2881 S. Valley View Blvd #6, Las Vegas, NV 89102 | 2019-09-13 |
| 1801445572 | Rafael Roberto Gonzalez Palomino | Homemaker | 4550 W. Oakey Blvd, Suite 111-0, Las Vegas, NV 89102 | 2019-09-05 |
| Find all providers in zip 89102 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484734 | Accessible Space Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1405 South Mojave Rd, Las Vegas, NV 89104 | 2020-07-14 |
| 1285252742 | Accessible Space Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3209 Cedar St, Las Vegas, NV 89104-4472 | 2020-07-10 |
| 1649898107 | Accessible Space Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4935 N Miller Ln, Las Vegas, NV 89149-5201 | 2020-07-10 |
| 1336763903 | 360 Medhp LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2110 E Flamingo Rd Ste 360, Las Vegas, NV 89119-5190 | 2020-05-29 |
| 1447766670 | Kaes Cube of Life LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3909 S Maryland Pkwy Ste 305, Las Vegas, NV 89119-7520 | 2017-12-26 |
| 1639683469 | Ccf Health & Behavioral LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5109 Ackaburg Ct, Las Vegas, NV 89130-2148 | 2017-12-01 |
| 1689075780 | Helping Crusaders | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5388 Flowing Spring St, Las Vegas, NV 89122-7677 | 2014-09-08 |
| 1780964619 | Dialysis Care of Nevada | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5364 Harvest Breeze Rd, Las Vegas, NV 89118-2034 | 2011-08-23 |
| 1356650303 | Grace & Mercy Human Services,inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 880 Blankenship Ave, Las Vegas, NV 89106-2230 | 2010-09-24 |
| 1710505946 | Accessible Space Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6375 W Charleston Blvd Bldg L, Las Vegas, NV 89146-1139 | 2020-07-14 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.