Blue Rose Behavioral Health LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BLUE ROSE BEHAVIORAL HEALTH LLC

Practice address

1400 E Reno Ave Apt 52
Las Vegas, NV 89119-1681

Phone

(702) 927-5201

NPI assigned

Oct 5, 2021

Last updated

Oct 5, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jaynise PorterNPI 1508369828

Title

Owner

Phone

(702) 927-5201

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jaynise Porter

  • Case Manager/Care Coordinator
  • Las Vegas, NV
  • NPI 1508369828
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1003588211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E RENO AVE APT 52",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891191681",
            "telephone_number": "702-927-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E RENO AVE APT 52",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891191681",
            "telephone_number": "702-927-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ROSE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "JAYNISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-927-5201"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.