Vegas Innovative Psychiatry
Vegas Innovative Psychiatry · Clinic/Center (Multi-Specialty)

Address: 1721 E Charleston Blvd, Las Vegas, NV 89104-1902
Phone: 7026850620

Vegas Innovative Psychiatry (NPI# 1053931576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1053931576
Entity Type Organization
Organization Name VEGAS INNOVATIVE PSYCHIATRY
Other Organization Name VEGAS INNOVATIVE PSYCHIATRY
Practice Address 1721 E Charleston Blvd
Las Vegas
NV 89104-1902
Practice Telephone 7026850620
Practice Fax Number 7026859674
Mailing Address 1721 E Charleston Blvd
Las Vegas
NV 89104-1902
Mailing Telephone 7026850620
Mailing Fax Number 7026859674
Authorized Official Name Maria Fernanda Mitchell (PROGRAM DIRECTOR)
Authorized Official Telephone 7025801850
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2020-04-24
Last Update Date 2020-08-03

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 261QM1300X Clinic/Center · Multi-Specialty Ambulatory Health Care Facilities

Other Provider Identifier

State Identifier Issuer Type Code
NV E6055912020-0 MEDICAID

Other Provider/Organization Names

Other Name Type Code
Vegas Innovative Psychiatry Doing Business As Name - Organization

Providers with the same name

NPI Name Taxonomy Address Enumeration
1558981068 Vegas Innovative Psychiatry Psychologist 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 2020-04-24

Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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Office Location

Street Address 1721 E CHARLESTON BLVD
City LAS VEGAS
State NV
Zip Code 89104-1902

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932241007 Festus Ebonka Nurse Practitioner 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 2007-02-13
1699391011 Bright Star Urgent Care Clinic/Center 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 2020-06-22
1801412218 Matthew Okeke, M.d. Ltd Psychiatry & Neurology 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 2020-06-22
1699390427 Matthew Okeke, M.d. Ltd Clinic/Center 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 2020-06-08
1558981068 Vegas Innovative Psychiatry Psychologist 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 2020-04-24
1851933873 Ebony Relief Charitable Inc. Community/Behavioral Health 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 2019-10-10
1104308147 Nevada Integrated Behavioral Services Inc. Counselor 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 2018-09-06
1083158489 Melisa Stephens Community Health Worker 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 2016-12-05
1952852097 Nevada Integrated Behavioral Services Inc. Psychiatric Hospital 1721 E Charleston Blvd, 1721, Las Vegas, NV 89104-1902 2016-10-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1396398947 Martinez Antuan Coates Psychologist 1755 Palm St Bld T Apt147, Las Vegas, NV 89104 2019-07-23
1982171518 Ian Sande Occupational Therapist 1500 West Warm Springs Rd, Las Vegas, NV 89104 2018-11-01
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Competitor

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City LAS VEGAS
Zip Code 89104

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Dataset Information

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.