STATE OF NEVADA (NPI# 1114094562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114094562 |
| Entity Type | Organization |
| Organization Name | STATE OF NEVADA |
| Other Organization Name | STATE OF NEVADA, DHHS, DIVISION OF CHILD AND FAMILY SERVICES |
| Practice Address |
6171 W Charleston Blvd Bldg. # 12-14 Las Vegas NV 89146-1126 |
| Mailing Address |
6171 W Charleston Blvd Bldg. #11 Las Vegas NV 89146-1126 |
| Practice Telephone | 7024866166 |
| Mailing Telephone | 7024866100 |
| Mailing Fax Number | 7024866057 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JEFF MORROW (ADMINISTRATIVE SERVICES OFFICER) |
| Authorized Official Telephone | 7024866100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| State of Nevada, DHHS, Division of Child and Family Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314264 | State of Nevada | Community/Behavioral Health | 4600 Kietzke Lane Bldg D, Reno, NV 89502 | 2020-07-23 |
| 1821607193 | State of Nevada | Community/Behavioral Health | 6171 W Charleston Blvd Bldg 15, Las Vegas, NV 89146 | 2020-07-23 |
| 1316574064 | State of Nevada | Psychiatric Residential Treatment Facility | 2655 Enterprise Dr, Reno, NV 89512 | 2020-03-24 |
| 1114309432 | State of Nevada | Case Management | 3416 Goni Rd Bldg D, 132, Carson City, NV 89706-8008 | 2015-06-23 |
| 1699914887 | State of Nevada | Case Management | 775 Cornell Avenue, Suite A-1, Lovelock, NV 89419-0000 | 2009-02-11 |
| 1386805265 | State of Nevada | Public Health or Welfare | 1000 E Williams Street, #205, Carson City, NV 80701 | 2008-06-23 |
| 1558549972 | State of Nevada | Case Management | 100 Depot, #5, Caliente, NV 89008-0000 | 2008-02-07 |
| 1578741179 | State of Nevada | Case Management | 1665 Old Hot Springs Road, Suite 150, Carson City, NV 89706-0668 | 2008-02-06 |
| 1336203892 | State of Nevada | Public Health or Welfare | 1665 Old Hot Springs Rd Ste 157, Carson City, NV 89706-0663 | 2006-12-20 |
| 1184706012 | State of Nevada | Clinic/Center | 825 S Main, Tonopah, NV 89049-0494 | 2006-10-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | STATE OF NEVADA RURAL CLINICS | 4126 Technology Way 2nd Fl, Carson City, NV 89706-2027 |
| Street Address |
6171 W CHARLESTON BLVD BLDG. # 12-14 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89146-1126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811953003 | State of Nevada | Psychiatric Residential Treatment Facility | 6171 W Charleston Blvd, Bldg. #17, Las Vegas, NV 89146-1126 | 2006-04-25 |
| 1073112025 | Colette Olicia Scott | Counselor | 6171 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2020-10-21 |
| 1104423615 | Cleonne Lucien-ferdinand | Registered Nurse | 6171 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2020-10-07 |
| 1740805670 | Johnathan M Clark | Registered Nurse | 6171 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2020-06-16 |
| 1437780996 | Eva Maria Rivera | Registered Nurse | 6171 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2020-02-03 |
| 1699305953 | Margy Espinosa | Registered Nurse | 6171 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2020-01-24 |
| 1871123133 | Frances M. Twigg | Registered Nurse | 6171 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2020-01-24 |
| 1700429271 | Nancy Angela Zavetz-lee | Registered Nurse | 6171 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2019-10-28 |
| 1558822676 | Loribeth Smith | Counselor | 6171 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2019-03-29 |
| 1144795808 | Barbara A Jones | Counselor | 6171 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2018-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821607193 | State of Nevada | Community/Behavioral Health | 6171 W Charleston Blvd Bldg 15, Las Vegas, NV 89146 | 2020-07-23 |
| 1730726597 | Jenna Leigh White | Occupational Therapist | 2012 S Jones Blvd., Las Vegas, NV 89146 | 2019-11-28 |
| 1649828898 | Rocio Ferat | Chore Provider | 5000 W. Oakey Suite E.i, Las Vegas, NV 89146 | 2019-08-30 |
| 1912554007 | Juan Zamora | Chore Provider | 5000 W. Oakey Bld Suite E-1, Las Vegas, NV 89146 | 2019-08-22 |
| 1407402530 | Elia Rocio Vargas-sifuentes | Chore Provider | 5000 W Oakey, Suite E.i, Las Vegas, NV 89146 | 2019-08-14 |
| 1740834050 | Zi Wang | Physician Assistant | 5300 Spring Mountain Rd Ste 112, Las Vegas, NV 89146 | 2019-07-25 |
| 1871145565 | Virginia Lopez Lopez | Chore Provider | 5000 W. Oakey Blvd. Suite E-1, Las Vegas, NV 89146 | 2019-07-12 |
| 1962054726 | Nona Sixta Q Baldonado | Technician | 5450 W Sahara Ave Ste 250a, Las Vegas, NV 89146 | 2019-07-11 |
| 1326600701 | Thelma Moreno Cerros | Chore Provider | 5000 W. Oakey Blvd Suite E-1, Las Vegas, NV 89146 | 2019-07-05 |
| 1992367866 | Carolina Perez | Chore Provider | 5000 W Oakey Blvd Suite E-1, Las Vegas, NV 89146 | 2019-07-01 |
| Find all providers in zip 89146 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427659465 | Dr Therapy Mental Wellness Centers | Community Based Residential Treatment Facility, Mental Illness | 2915 W Charleston Blvd Ste 125, Las Vegas, NV 89102-1939 | 2020-11-05 |
| 1891395869 | Brighter Development Behavorial Health Services | Community Based Residential Treatment Facility, Mental Illness | 3228 Villa Fiori Avenue, Las Vegas, NV 89141 | 2020-10-29 |
| 1427692532 | 3r Holdings LLC | Community Based Residential Treatment Facility, Mental Illness | 2860 S Bronco St, Las Vegas, NV 89146-5208 | 2019-10-31 |
| 1265093934 | Synergy Health | Community Based Residential Treatment Facility, Mental Illness | 9472 Wakashan Ave, Las Vegas, NV 89149-0502 | 2019-06-24 |
| 1023676129 | Butterfly Wings LLC | Community Based Residential Treatment Facility, Mental Illness | 9445 Coral Berry St, Las Vegas, NV 89123-5832 | 2019-06-03 |
| 1477118198 | Cece Group Home, LLC | Community Based Residential Treatment Facility, Mental Illness | 5417 Ireland St, Las Vegas, NV 89149 | 2019-05-08 |
| 1285191981 | A New Brighter Future | Community Based Residential Treatment Facility, Mental Illness | 50 N Honolulu St, Las Vegas, NV 89110-4301 | 2019-02-28 |
| 1912471814 | Latoya Rodgers | Community Based Residential Treatment Facility, Mental Illness | 1172 Warm Canyon Way, Las Vegas, NV 89123-3601 | 2019-01-14 |
| 1760959522 | Beehive Homes of Paradise Valley Inc | Community Based Residential Treatment Facility, Mental Illness | 3841 E Twain Ave, Las Vegas, NV 89121-4520 | 2018-10-30 |
| 1811478712 | Malaika Tamu Hadley Jaffe | Community Based Residential Treatment Facility, Mental Illness | 6644 Jordan River Dr, Las Vegas, NV 89156 | 2018-08-28 |
| Find all providers in LAS VEGAS | ||||
Please comment or provide details below to improve the information on STATE OF NEVADA.
| 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.