CHARLESTON RESIDENTIAL MEDICINE LLC


Address: 2121 W Charleston Blvd, Las Vegas, NV 89102-2205
Phone: 7023827746

CHARLESTON RESIDENTIAL MEDICINE LLC (NPI# 1841769429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1841769429
Entity Type Organization
Organization Name CHARLESTON RESIDENTIAL MEDICINE LLC
Other Organization Name CROSSROADS COMPREHENSIVE CARE
Practice Address 2121 W Charleston Blvd
Las Vegas
NV 89102-2205
Practice Telephone 7023827746
Mailing Telephone 7023827746
Enumeration Date 2018-11-13
Last Update Date 2019-04-04
Authorized Official Name JENNIFER LYNN MORSS (CHIEF OPERATING OFFICER)
Authorized Official Telephone 7023323228
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
CrossRoads Comprehensive Care Doing Business As Name - Organization

Office Location

Street Address 2121 W CHARLESTON BLVD
City LAS VEGAS
State NV
Zip Code 89102-2205

Providers in the same location

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
1790253060 Charleston Residential Services LLC Substance Abuse Rehabilitation Facility 2121 W Charleston Blvd, Las Vegas, NV 89102-2205 2018-11-05
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

Providers in the same zip code

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 Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578162848 Desert Teleheart Inc Internal Medicine 12384 Middle Creek St, Las Vegas, NV 89138 2020-10-19
1962018531 Sanaz Siran Md Pllc Internal Medicine 2893 Red Springs Dr, Las Vegas, NV 89135-1514 2020-09-19
1215546932 5 Star Medical Health Services LLC Internal Medicine 1363 W Owens Ave, Las Vegas, NV 89106-2432 2020-07-28
1376160291 Qazi, Ribeiro, and Shah Pllc Internal Medicine 1925 Village Center Cir Ste 150, Las Vegas, NV 89134-6261 2020-06-26
1639791791 Spring Mountain Medical Center Pllc Internal Medicine 4276 Spring Mountain Rd Unit 211, Las Vegas, NV 89102-8781 2020-05-12
1720609555 Alia Parveen Inc Internal Medicine 337 Rezzo St, Las Vegas, NV 89138-4624 2020-05-04
1225658982 Ejo Mannaparambil John Md Pllc Internal Medicine 3217 Grayson Lake Ct, Las Vegas, NV 89129-6614 2020-04-23
1780203869 Curry Pllc Internal Medicine 8535 Edna Ave, Las Vegas, NV 89117-4413 2020-04-09
1073142980 Fajar Corp LLC Internal Medicine 2991 Raywood Ash Dr, Las Vegas, NV 89138-6143 2020-04-02
1912534348 Garrison Medical Consultants Pllc Internal Medicine 6852 Sumatra St, Las Vegas, NV 89166-7001 2020-03-25
Find all providers in LAS VEGAS

Competitor

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City LAS VEGAS
Zip Code 89102

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Dataset Information

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.

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