STEADFAST BEHAVIORAL CLINIC LLC (NPI# 1447866801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447866801 |
| Entity Type | Organization |
| Organization Name | STEADFAST BEHAVIORAL CLINIC LLC |
| Practice Address |
8612 Copper Knoll Ave Las Vegas NV 89129-7649 |
| Practice Telephone | 3233386101 |
| Mailing Telephone | 3233386101 |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2020-09-21 |
| Authorized Official Name | MA VICTORIA ESCARDA (MANAGING MEMBER) |
| Authorized Official Telephone | 3233386101 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8612 COPPER KNOLL AVE |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89129-7649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699387621 | Voice Specialist LLC | Speech-Language Pathologist | 3701 Paul Deweert Ct, Las Vegas, NV 89129 | 2020-08-20 |
| 1215563358 | Aba Homecare LLC | In Home Supportive Care | 4456 N Prospect Hill Ct, Las Vegas, NV 89129 | 2020-03-20 |
| 1568935534 | Las Vegas Family Medicine Inc. | Family Medicine | 7660 W. Cheyenne Ave Suite 110, Las Vegas, NV 89129 | 2019-01-02 |
| 1477040798 | Cynthia Beverly Springer | Technician | 8670 West Cheyenne Suite 135, Las Vegas, NV 89129 | 2018-04-23 |
| 1518471093 | 3 Pharmacy LLC | Pharmacy | 3350 Novat St Ste 110, Las Vegas, NV 89129 | 2017-11-20 |
| 1497207393 | Morgan A Lavergne | Behavioral Analyst | 7650 Siesta Grande Ave., Las Vegas, NV 89129 | 2016-10-27 |
| 1255880191 | Sierra Treatment and Recovery Services, LLC | Clinic/Center | 3321 N. Buffalo Dr., Suite #125, Las Vegas, NV 89129 | 2016-10-03 |
| 1710433545 | Tyson Miller | Dentist | 3600 N Buffalo Dr., #110, Las Vegas, NV 89129 | 2016-08-31 |
| 1427450923 | Jerale Tiffith | Behavioral Analyst | 3800 Dalecrest Dr., 2801, Las Vegas, NV 89129 | 2014-09-16 |
| 1134463821 | Paul Carr | Behavioral Analyst | 4460 Park Ave, Las Vegas, NV 89129 | 2012-11-19 |
| Find all providers in zip 89129 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404074 | Ibukun Odutola | Nurse Practitioner | 2605 E Flamingo Rd, Las Vegas, NV 89121-5241 | 2020-07-14 |
| 1225652191 | Angela Beth Wilson | Nurse Practitioner | 5440 W Sahara Ave Ste 220, Las Vegas, NV 89146-0355 | 2020-06-05 |
| 1104445394 | Universal Psychiatry LLC | Nurse Practitioner | 270 E Flamingo Rd Unit 122, Las Vegas, NV 89169-0325 | 2020-04-09 |
| 1952931271 | Paramount Healthcare Services Corp | Nurse Practitioner | 10141 Rockridge Peak Ave, Las Vegas, NV 89166-5200 | 2020-01-26 |
| 1730642182 | Aban Medical Services | Nurse Practitioner | 10145 Eagle Haven St, Las Vegas, NV 89141-8781 | 2019-04-11 |
| 1750857728 | Jan Michael Arceo | Nurse Practitioner | 3140 S Rainbow Blvd Ste 401, Las Vegas, NV 89146-6234 | 2018-10-17 |
| 1780110247 | Jon A Failla Aprn Pllc | Nurse Practitioner | 182 Apache Tear Ct, Las Vegas, NV 89123-2996 | 2017-05-03 |
| 1023565074 | Bright Star Nurse Care LLC | Nurse Practitioner | 8337 Fox Brook St, Las Vegas, NV 89139-6755 | 2016-09-07 |
| 1467805119 | Kasey James Dean | Nurse Practitioner | 3321 N Buffalo Dr, Suite 200, Las Vegas, NV 89129-6678 | 2016-07-18 |
| 1558757021 | Martin Binyange | Nurse Practitioner | 320 E Warm Springs Rd Unit 1, Las Vegas, NV 89119-4243 | 2015-04-12 |
| 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.