PHOENIX RISING BEHAVIORAL HEALTH LLC (NPI# 1912559584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912559584 |
| Entity Type | Organization |
| Organization Name | PHOENIX RISING BEHAVIORAL HEALTH LLC |
| Practice Address |
618 Gilday Ct N Las Vegas NV 89030-4059 |
| Practice Telephone | 4075340646 |
| Mailing Telephone | 4075340646 |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |
| Authorized Official Name | MR. STEVIE JEROME BOUYER II (OWNER) |
| Authorized Official Telephone | 4075340646 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PHOENIX RISING BEHAVIORAL HEALTH LLC | 180 S Broadway, Suite 301-b, White Plains, Ny 10605 |
| Street Address |
618 GILDAY CT |
| City | N LAS VEGAS |
| State | NV |
| Zip Code | 89030-4059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043819063 | Ma Guadalupe Ramos Michel | Technician | 2415 Reynolds Ave #101, Las Vegas, NV 89030 | 2020-10-21 |
| 1558968214 | Arturo Juarez Magana | Technician | 2415 Reynolds Ave Suite 101, Las Vegas, NV 89030 | 2020-10-06 |
| 1669088407 | Olivia Lizbeth Santillan-trinidad | Technician | 2415 Reynolds Ave. Ste #101, Las Vegas, NV 89030 | 2020-09-17 |
| 1508471640 | Fabian Aaron Alvarado-perales | Technician | 2415 Reynolds Ave Ste. 101, Las Vegas, NV 89030 | 2020-09-15 |
| 1063047934 | Adriana Lopez | Technician | 2415 Reynolds Ave., Ste 100, N. Las Vegas, NV 89030 | 2020-03-11 |
| 1881234078 | Blanca E Rangel Silva | Technician | 2810 Equador Ct, Las Vegas, NV 89030 | 2020-01-15 |
| 1598314445 | Julia Gonzalez | Technician | 2415 Reynolds Ave Suiete 100, Las Vegas, NV 89030 | 2019-09-04 |
| 1487201901 | Mayra Gutierrez | Technician | 2415 Reynolds Av. #100, Las Vegas, NV 89030 | 2019-08-20 |
| 1639725799 | Idalia Ruiz | Technician | 2415 Reynolds Ave, Las Vegas, NV 89030 | 2019-08-14 |
| 1548815616 | Rd Prabhu-lata K Shete Mds Ltd | Clinic/Center | 1905 Civic Center Drive, Ste 201, N. Las Vegas, NV 89030 | 2019-08-06 |
| Find all providers in zip 89030 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831724285 | Halo Behavioral Health LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3517 Freestone Ln, N Las Vegas, NV 89032-0532 | 2020-03-05 |
| 1841843190 | Night Owl Crisis Center LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2701 Shield St, N Las Vegas, NV 89030-3891 | 2019-07-16 |
| 1386147304 | Footsteps Toward Solutions LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4411 Buck Creek Cir, N Las Vegas, NV 89032-0131 | 2018-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306460480 | Greater Heights Behavioral Health, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3355 S Town Center Dr Apt 1027, Las Vegas, NV 89135-3001 | 2020-06-03 |
| 1467075226 | Klasic Mindset LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4550 W Oakey Blvd Ste 97, Las Vegas, NV 89102-1506 | 2020-05-27 |
| 1255980074 | Clark County Medical Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2680 Karen Ave Apt 1, Las Vegas, NV 89121-1158 | 2019-09-04 |
| 1407418601 | Josephs House LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8600 W Charleston Blvd Unit 208, Las Vegas, NV 89117-5407 | 2019-07-08 |
| 1962062901 | Healing Every Last Person | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9278 W Russell Rd, Las Vegas, NV 89148-1316 | 2019-06-20 |
| 1669032546 | Tancell Care LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4000 S Eastern Ave Ste 150, Las Vegas, NV 89119-0840 | 2019-06-13 |
| 1699333773 | L and M Providers | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1832 N Decatur Blvd, Las Vegas, NV 89108-2264 | 2019-06-03 |
| 1184281750 | Better Behavior Health Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7345 S Durango Dr # 107-271, Las Vegas, NV 89113-3653 | 2019-05-20 |
| 1487217725 | Meaningful Solutions | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6717 W Charleston Blvd, Las Vegas, NV 89146-9204 | 2019-04-22 |
| 1932662913 | Behavior Support Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6317 Pageant St, North Las Vegas, NV 89031-6300 | 2019-04-08 |
| Find all providers with the same taxonomy | ||||
| City | N LAS VEGAS |
| Zip Code | 89030 |
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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.