CHARLESTON RESIDENTIAL SERVICES LLC (NPI# 1558864439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558864439 |
| Entity Type | Organization |
| Organization Name | CHARLESTON RESIDENTIAL SERVICES LLC |
| Other Organization Name | CROSSROADS OF SOUTHERN NEVADA |
| Practice Address |
2121 W Charleston Blvd Las Vegas NV 89102-2205 |
| Practice Telephone | 7023827746 |
| Mailing Telephone | 7023827746 |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2018-03-16 |
| Authorized Official Name | JENNIFER LYNN MORSS (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 7023323228 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | NV | Agencies |
| Other Name | Type Code |
|---|---|
| CrossRoads of Southern Nevada | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083167290 | Charleston Residential Services LLC | Custodial Care Facility | 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 | 2016-07-25 |
| 1790253060 | Charleston Residential Services LLC | Substance Abuse Rehabilitation Facility | 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 | 2018-11-05 |
| Street Address |
2121 W CHARLESTON BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89102-2205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083167290 | Charleston Residential Services LLC | Custodial Care Facility | 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 | 2016-07-25 |
| 1689204513 | David L Hurd | Case Manager/Care Coordinator | 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 | 2020-01-20 |
| 1700433109 | Amanda Jurden | Social Worker | 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 | 2019-08-20 |
| 1528530763 | Evans Yonyon Azagidi | Nurse Practitioner | 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 | 2018-12-28 |
| 1841769429 | Charleston Residential Medicine LLC | Internal Medicine | 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 | 2018-11-13 |
| 1790253060 | Charleston Residential Services LLC | Substance Abuse Rehabilitation Facility | 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 | 2018-11-05 |
| 1053850636 | Robert Soucy | Counselor | 2121 W Charleston Blvd, Las Vegas, NV 89102 | 2017-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998397 | Natasha Moore | Technician | 3210 W Charleston Suite 2, Las Vegas, NV 89102 | 2020-10-07 |
| 1568077113 | Zulma Yaneth Tervizo Lopez | Technician | 455 W Oakey Blvd, Ste 111, Las Vegas, NV 89102 | 2020-09-10 |
| 1922629765 | Bianca Vaudreuil | Religious Nonmedical Practitioner | 3210 W Charleston Ste 2, Las Vegas, NV 89102 | 2020-05-04 |
| 1720608052 | Angelica Gutierrez | Technician | Vegas Compassionate Care ; 2820 W. Charleston Blvd B-21, Las Vegas, NV 89102 | 2020-04-16 |
| 1396370680 | Juana Maria Hernandez | Technician | 2881 S. Valley View Blvd, Suite #6, Las Vegas, NV 89102 | 2020-03-06 |
| 1609409648 | Janie Washington | Technician | 3210 W Charleston Blvd. Suite 2, Las Vegas, NV 89102 | 2020-02-18 |
| 1447893185 | Maria Josefina Castaneda | Technician | 2881 S. Valley View Blvd Suite #6, Los Vegas, NV 89102 | 2019-10-25 |
| 1427608777 | Virginia Hernandez Tolentino | Technician | 4550 W Oakley Blvd, Suite 101 A, Las Vegas, NV 89102 | 2019-09-18 |
| 1972153872 | Gladiola Cardoza Quinones | Technician | 2881 S. Valley View Blvd #6, Las Vegas, NV 89102 | 2019-09-13 |
| 1801445572 | Rafael Roberto Gonzalez Palomino | Homemaker | 4550 W. Oakey Blvd, Suite 111-0, Las Vegas, NV 89102 | 2019-09-05 |
| Find all providers in zip 89102 | ||||
| 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.