JEFFERSON FAMILY CORPORATION, INC (NPI# 1295397297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295397297 |
| Entity Type | Organization |
| Organization Name | JEFFERSON FAMILY CORPORATION, INC |
| Practice Address |
304 S. Jones Blvd Suite #3673 Las Vegas NV 89107 |
| Mailing Address |
304 S. Jones Blvd. Suite #3673 Las Vegas NV 89107 |
| Practice Telephone | 7026843573 |
| Practice Fax Number | 7025486891 |
| Mailing Telephone | 7026843573 |
| Mailing Fax Number | 7025486891 |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2019-07-01 |
| Authorized Official Name | ANNIE MAE SPENCER (OWNER) |
| Authorized Official Telephone | 7026843573 |
| Is Organization Subpart | Y |
| Parent Organization Name | JEFFERSON FAMILY CORPORATION, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Cognisive Clinic: The Center for Brain Health | Doing Business As Name - Organization |
| Street Address |
304 S. JONES BLVD SUITE #3673 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942837620 | Dominica Marie Lemay | Technician | Ideal Staffing Inc 500 N Rainbow Blvd Ste 300 Las Vegas, Las Vegas, NV 89107 | 2020-03-24 |
| 1417589854 | Ciro Zuniga | Technician | 5020 Alta Dr Suit-b, Las Vegas, NV 89107 | 2020-02-04 |
| 1730729252 | Natalie Rochelle Ross | Technician | Ideal Staffing Inc N Rainbow Blvd Ste 300 Las Vegas, Nv, Las Vegas, NV 89107 | 2020-01-13 |
| 1679112148 | Cynthia Mayen | Technician | 2050 Alta Dr. Suit - B, Las Vegas, NV 89107 | 2020-01-02 |
| 1427695543 | Aaa Physical Therapy LLC | Clinic/Center | 633 N. Decatur Blvd., Suite E, Las Vegas, NV 89107 | 2019-12-09 |
| 1063061018 | Guaoalupe Pena | Technician | 5020 Alta Dr. Suit - B, Las Vegas, NV 89107 | 2019-09-11 |
| 1275180234 | Roman Bautista Ortiz | Technician | 5020 Alta Dr. Suit-b, Las Vegas, NV 89107 | 2019-08-23 |
| 1518513357 | Michele Renee Black | Chore Provider | 500 North Rainbow Boulevard, Suite 300, Las Vegas, NV 89107 | 2019-08-16 |
| 1124674312 | Helena Alma Ferron-zepeda | Technician | 5020 Alta Dr., Suite-b, Las Vegas, NV 89107 | 2019-08-13 |
| 1386299246 | Felecia Ann Goodwin | Technician | 500 N Rainbow Blvd Ste 300, Ideal Staffing Inc, Las Vegas, NV 89107 | 2019-08-07 |
| Find all providers in zip 89107 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698556 | Therapy of Southern Nevada | Community/Behavioral Health | 4100 W Flamingo Rd Ste 1442, Las Vegas, NV 89103-3924 | 2020-10-30 |
| 1114527355 | Nevada Behavioral Services | Community/Behavioral Health | 2880 E Flamingo Rd Ste G, Las Vegas, NV 89121-5223 | 2020-10-27 |
| 1295341733 | P Saint Roc LLC | Community/Behavioral Health | 1700 Alta Dr Apt 2124, Las Vegas, NV 89106-4174 | 2020-09-21 |
| 1609482181 | Kristie Leialoha Dias | Community/Behavioral Health | 9986 Catseye Cove Ct, Las Vegas, NV 89183-7203 | 2020-09-19 |
| 1326653551 | Serene Behavioral Health LLC | Community/Behavioral Health | 5800 W Charleston Blvd Apt 2051, Las Vegas, NV 89146-1297 | 2020-09-14 |
| 1124630678 | Robert Thomas Marbury IIi | Community/Behavioral Health | 501 S Rancho Dr Ste B10, Las Vegas, NV 89106-4830 | 2020-08-17 |
| 1124637335 | Monica Petroff | Community/Behavioral Health | 3540 W Sahara Ave #e6, Las Vegas, NV 89102-9253 | 2020-07-24 |
| 1821607193 | State of Nevada | Community/Behavioral Health | 6171 W Charleston Blvd Bldg 15, Las Vegas, NV 89146 | 2020-07-23 |
| 1023635273 | Greatness Through Wellness Services | Community/Behavioral Health | 2350 S Jones Blvd Ste 206mon85, Las Vegas, NV 89146-3103 | 2020-07-02 |
| 1568088391 | Bridgeway Family Services LLC | Community/Behavioral Health | 11186 Fort Bowie St, Las Vegas, NV 89179-1223 | 2020-06-17 |
| Find all providers in LAS VEGAS | ||||
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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.