STATE OF NEVADA (NPI# 1891756920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891756920 |
| Entity Type | Organization |
| Organization Name | STATE OF NEVADA |
| Other Organization Name | SOUTHERN NEVADA ADULT MENTAL HEALTH SERVICES |
| Practice Address |
6161 W Charleston Blvd Las Vegas NV 89146-1126 |
| Mailing Address |
4150 Technology Way Carson City NV 89706-2026 |
| Practice Telephone | 7024866000 |
| Practice Fax Number | 7024868077 |
| Mailing Telephone | 7024866000 |
| Mailing Fax Number | 7024868077 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2017-01-13 |
| Authorized Official Name | MR. MICHAEL ALLERDYCE (RATES AND COST CONTAINMENT MANAGER) |
| Authorized Official Telephone | 7756845952 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 283Q00000X | Psychiatric Hospital | Hospitals | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
PH02110 | NV | Suppliers |
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2052189 | 01 |
| Other Name | Type Code |
|---|---|
| SOUTHERN NEVADA ADULT MENTAL HEALTH SERVICES | Other Name - Individual/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 |
6161 W CHARLESTON BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89146-1126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265055222 | John Potter | Counselor | 6161 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2020-05-26 |
| 1174165021 | Liza Anne Lara | Social Worker | 6161 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2019-10-11 |
| 1407357114 | Joann Mundin | Psychiatry & Neurology | 6161 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2018-02-27 |
| 1316345788 | Alma Bautista Manlangit | Registered Nurse | 6161 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2014-12-16 |
| 1770997926 | Sean Elder | Specialist/Technologist, Other | 6161 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2014-06-16 |
| 1649684028 | Christopher Fyfe | Psychologist | 6161 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2014-06-13 |
| 1770995656 | Brooks One Recovery Services | Nurse Practitioner | 6161 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2014-05-27 |
| 1770903437 | Michael Cooper | Social Worker | 6161 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2014-04-21 |
| 1396160347 | Timothy Wathen | Registered Nurse | 6161 W Charleston Blvd, Bldg 1, Las Vegas, NV 89146-1126 | 2014-02-27 |
| 1033533872 | Acel Carlos | Registered Nurse | 6161 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2014-02-14 |
| 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 | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215558143 | Jessica Mix Mft | Clinic/Center | 6390 W Cheyenne Ave Ste F, Las Vegas, NV 89108-6008 | 2020-05-01 |
| 1528695897 | L Jensen and Associates Inc | Clinic/Center | 9418 W Lake Mead Blvd Ste 308, Las Vegas, NV 89134-8312 | 2020-03-25 |
| 1013548817 | Abraxas Center LLC | Clinic/Center | 4575 W Cougar Ave Ste 300, Las Vegas, NV 89139-7617 | 2020-01-30 |
| 1164061818 | Therapy Sense Pllc | Clinic/Center | 9402 W Lake Mead Blvd Ofc 104, Las Vegas, NV 89134-8312 | 2019-12-28 |
| 1932748779 | Mindworks Mental Health Clinic | Clinic/Center | 3830 Timberlake Dr., Las Vegas, NV 89115 | 2019-12-26 |
| 1205479813 | Core Strength LLC | Clinic/Center | 186 Woolman Rink Ave, Las Vegas, NV 89123-7443 | 2019-10-26 |
| 1164987871 | Brenda Primero Np LLC | Clinic/Center | 8125 Nottingham Hill Ln, Las Vegas, NV 89113-1888 | 2019-02-06 |
| 1699281915 | Desert Wellness Center | Clinic/Center | 3341 Ascona Ct, Las Vegas, NV 89129-6190 | 2017-12-22 |
| 1821537242 | Nicole R Vaughn Changing Minds | Clinic/Center | 911 N Buffalo Dr Unit 206, Las Vegas, NV 89128-0381 | 2017-02-17 |
| 1376090910 | Renaissance Ranch Outpatient, LLC | Clinic/Center | 3037 E Warm Springs Rd, Suite 400, Las Vegas, NV 89120-3758 | 2016-09-01 |
| 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.