CHARLESTON RESIDENTIAL SERVICES LLC (NPI# 1790253060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790253060 |
| Entity Type | Organization |
| Organization Name | CHARLESTON RESIDENTIAL SERVICES LLC |
| Practice Address |
2121 W Charleston Blvd Las Vegas NV 89102-2205 |
| Practice Telephone | 7023827746 |
| Mailing Telephone | 7023827746 |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-05 |
| 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 | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| 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 |
| 1558864439 | Charleston Residential Services LLC | Community/Behavioral Health | 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 | 2018-03-16 |
| 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 |
| 1558864439 | Charleston Residential Services LLC | Community/Behavioral Health | 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 | 2018-03-16 |
| 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 | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548879638 | Luxe Treatment Center LLC | Substance Abuse Rehabilitation Facility | 4845 N Riley St, Las Vegas, NV 89149-4124 | 2020-07-24 |
| 1891312005 | Hope Street LLC | Substance Abuse Rehabilitation Facility | 4465 S Buffalo Dr Ste B, Las Vegas, NV 89147-5006 | 2020-07-03 |
| 1407483456 | There Is No Hero In Heroin (tinhih) | Substance Abuse Rehabilitation Facility | 900 Karen Ave Ste D206, Las Vegas, NV 89109-1273 | 2020-03-26 |
| 1629609441 | Ignite Teen Treatment, LLC | Substance Abuse Rehabilitation Facility | 4465 S Buffalo Dr Ste D, Las Vegas, NV 89147-5006 | 2020-01-30 |
| 1144851437 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 4011 Mcleod Dr Unit A, Las Vegas, NV 89121-4305 | 2020-01-27 |
| 1740810316 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 4011 Mcleod Dr Unit B, Las Vegas, NV 89121-4305 | 2020-01-22 |
| 1003451584 | Nevada Rehab LLC | Substance Abuse Rehabilitation Facility | 2651 Westwood Dr, Las Vegas, NV 89109-1117 | 2019-11-08 |
| 1578118717 | Vegas Wellness Treatment Center | Substance Abuse Rehabilitation Facility | 3920 W Charleston Blvd Ste N, Las Vegas, NV 89102-1651 | 2019-08-05 |
| 1629635644 | Thrive Solutions LLC | Substance Abuse Rehabilitation Facility | 5510 S Fort Apache Rd Ste 13, Las Vegas, NV 89148-7700 | 2019-05-24 |
| 1215436605 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 6655 W Sahara Ave Ste D208, Las Vegas, NV 89146-0851 | 2018-02-12 |
| 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.