ODYSSEY HOUSE, INC. (NPI# 1326588864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326588864 |
| Entity Type | Organization |
| Organization Name | ODYSSEY HOUSE, INC. |
| Other Organization Name | ODYSSEY HOUSE |
| Practice Address |
2810 W Charleston Blvd Ste 70 Las Vegas NV 89102-1993 |
| Practice Telephone | 8014283487 |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |
| Authorized Official Name | JOANNA R. WHEELTON (DIRECTOR OF ADMINISTRATION) |
| Authorized Official Telephone | 8014283487 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
SAPTA | NV | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Odyssey House | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912108390 | Odyssey House, Inc. | Clinic/Center | 367 Shaker Rd, Canterbury, NH 03224-2736 | 2007-05-31 |
| 1295936656 | Odyssey House, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 124 Landing Rd, Hampton, NH 03842-2603 | 2007-05-31 |
| 1295936730 | Odyssey House, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 30 Winnacunnet Rd, Hampton, NH 03842-2121 | 2007-05-31 |
| 1811351307 | Odyssey House, Inc. | Community/Behavioral Health | 953 Southern Blvd, Suite 301, Bronx, NY 10459-3428 | 2016-04-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ODYSSEY HOUSE, INC. (UTAH) | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 |
| Street Address |
2810 W CHARLESTON BLVD STE 70 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89102-1993 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740588847 | Maria Ivanovna Semenihina | Counselor | 2810 W Charleston Blvd Ste 70, Las Vegas, NV 89102-1909 | 2011-03-14 |
| 1235545369 | Maral Jacobs | Counselor | 2810 W Charleston Blvd Ste 70, Las Vegas, NV 89102-1909 | 2014-07-09 |
| 1770920159 | Freddie Lopez | Rehabilitation Practitioner | 2810 W Charleston Blvd Ste 70, Las Vegas, NV 89102-1993 | 2013-05-27 |
| 1245572502 | Derek Thomas Brown | Counselor | 2810 W Charleston Blvd Ste 70, Las Vegas, NV 89102-1909 | 2013-03-25 |
| 1669724100 | Michelle A Halberg | Counselor | 2810 W Charleston Blvd Ste 70, Las Vegas, NV 89102-1909 | 2012-10-08 |
| 1982953253 | Diamond Carson | Counselor | 2810 W Charleston Blvd Ste 70, Las Vegas, NV 89102-1909 | 2012-09-02 |
| 1700133774 | Beth Barfield | Counselor | 2810 W Charleston Blvd Ste 70, Las Vegas, NV 89102-1909 | 2012-08-09 |
| 1225383946 | Beacon Pointe Nv, LLC | Community/Behavioral Health | 2810 W Charleston Blvd Ste 70, Las Vegas, NV 89102-1909 | 2012-07-18 |
| 1811256910 | Maxine Hall | Counselor | 2810 W Charleston Blvd Ste 70, Las Vegas, NV 89102-1909 | 2012-05-09 |
| 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 | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629637509 | Help of Southern Nevada | Substance Abuse Rehabilitation Facility | 1640 E Flamingo Rd, Las Vegas, NV 89119-5249 | 2019-06-13 |
| 1144787813 | Adversities N Time LLC | Substance Abuse Rehabilitation Facility | 820 E Charleston Blvd, Las Vegas, NV 89104-1512 | 2019-02-28 |
| 1700303435 | Kingdom Investment Networking Group | Substance Abuse Rehabilitation Facility | 5715 W Alexander Rd Ste 110, Las Vegas, NV 89130-2815 | 2017-08-24 |
| 1710424288 | Nevada Homes for Youth | Substance Abuse Rehabilitation Facility | 525 S 13th St, Las Vegas, NV 89101-7203 | 2017-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609361088 | Douglas County and Unincorporated Towns | Substance Abuse Rehabilitation Facility | China Spring Youth Camp Adapt, 225 China Spring Road, Gardnerville, NV 89410 | 2018-06-27 |
| 1437595568 | White Pine Boys Ranch, LLC | Substance Abuse Rehabilitation Facility | Hc 34 Box 34165, Ely, NV 89301-9206 | 2013-05-15 |
| 1235486911 | Quest Counseling and Consulting | Substance Abuse Rehabilitation Facility | 1453 Pass Dr, Reno, NV 89509-3163 | 2012-08-13 |
| 1376102251 | Help of Southern Nevada | Substance Abuse Rehabilitation Facility | 3755 W Lake Mead Blvd, N Las Vegas, NV 89032-4897 | 2019-06-13 |
| 1982044087 | Christopher Vega | Substance Abuse Rehabilitation Facility | 3500 Lakeside Ct Ste 101, Reno, NV 89509-4862 | 2013-07-03 |
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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.