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).
| 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 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 261QM1300X | Clinic/Center · Multi-Specialty | Ambulatory Health Care Facilities |
| State | Identifier | Issuer | Type Code |
|---|---|---|---|
| NV | E6055912020-0 | MEDICAID |
| Other Name | Type Code |
|---|---|
| Vegas Innovative Psychiatry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558981068 | Vegas Innovative Psychiatry | Psychologist | 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 | 2020-04-24 |
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184247496 | Quality Health Center, LLC | Clinic/Center | 501 S Rancho Dr Ste I61, Las Vegas, NV 89106-4838 | 2020-05-20 |
| 1407310279 | Soul Purpose Sober Living LLC | Clinic/Center | 3667 El Camino Rd, Las Vegas, NV 89103-1102 | 2019-01-25 |
| 1295227379 | Ram K Singh Md Ltd | Clinic/Center | 4510 S Eastern Ave Ste 3, Las Vegas, NV 89119-6118 | 2018-06-04 |
| 1790293900 | True Hearts Behavioral Services,llc | Clinic/Center | 5415 W Harmon Ave, Las Vegas, NV 89103-5098 | 2018-01-22 |
| 1023420759 | Women's Cancer Center Division of Colorectal Surgery | Clinic/Center | 3131 La Canada St Ste 241, Las Vegas, NV 89169-2588 | 2014-05-29 |
| 1063849313 | Rutishauser LLC | Clinic/Center | 3061 S. Maryland Pkwy, Suite #104, Las Vegas, NV 89109-6226 | 2013-10-02 |
| 1518196765 | Oband Bernstein Medical Group, Ltd | Clinic/Center | 4440 South Eastern Ave, Las Vegas, NV 89119-7825 | 2009-07-09 |
| 1750568754 | Las Vegas Family Clinic | Clinic/Center | 1311 S Casino Center Blvd, Las Vegas, NV 89104-1105 | 2008-01-22 |
| 1619582830 | Lend A Hand LLC | Clinic/Center | 4091 Asante Cove St, Las Vegas, NV 89115-3511 | 2020-09-14 |
| 1033776117 | Thomas Yee, M.d. P.C. | Clinic/Center | 1120 Shadow Ln, Las Vegas, NV 89102-2342 | 2019-05-23 |
| Find all providers in LAS VEGAS | ||||
| Street Address |
1721 E CHARLESTON BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89104-1902 |
| 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 |
| 1699225599 | Ebonny Ventures Inc | Clinic/Center | 1721 E Charleston Blvd, 1721, Las Vegas, NV 89104-1902 | 2016-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550635 | Comfort Care Senior Services LLC | In Home Supportive Care | 1601 S Sandhill Rd, 62, Las Vegas, NV 89104 | 2020-08-26 |
| 1508484734 | Accessible Space Inc. | Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1405 South Mojave Rd, Las Vegas, NV 89104 | 2020-07-14 |
| 1003448333 | Shirley Lauren Valenzona-gianan | Pharmacist | Smith's Pharmacy #318, 4965 East Sahara Avenue, Las Vegas, NV 89104 | 2020-02-05 |
| 1427602713 | Alma Lucia Lozano-vargas | Chore Provider | 1785 E. Sahara Ave. Suite 485, Las Vegas, NV 89104 | 2019-07-25 |
| 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 |
| 1215436563 | A Better Life In Home Care, LLC | Technician | 1810 East Sahara Avenue, Suite 216, Las Vegas, NV 89104 | 2018-02-01 |
| 1891202016 | Nevada Helping Hands LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1810 E Sahara Ave Ste 143, Las Vegas, NV 89104 | 2018-01-09 |
| 1760901581 | Fannie Bell | Counselor | 1800 E. Sahara Suite 104, Las Vegas, NV 89104 | 2017-09-13 |
| 1386162147 | Jaclyn Mustachio | Social Worker | 1860 E Sahara Ave, Las Vegas, NV 89104 | 2017-08-31 |
| Find all providers in zip 89104 | ||||
Please comment or provide details below to improve the information on Vegas Innovative Psychiatry.
| 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.