NPIMap

Organization Active NPI

Medical and Behavioral Health Center LLC

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1023721065
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL AND BEHAVIORAL HEALTH CENTER LLC
Practice address
4225 S Eastern Ave Ste 8
Las Vegas, NV 89119-5485
Phone
(725) 204-0953
Fax
(702) 552-0302
NPI assigned
Jan 5, 2023
Last updated
Nov 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Authorized official

Name
Ms. Emilie PalabasanNPI 1053078063
Title
Member
Phone
(225) 371-1230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

4225 S Eastern Ave Ste 8
Las Vegas, NV 89119-5485

Mailing address

1363 W Owens Ave
Las Vegas, NV 89106-2432
Phone (725) 204-0953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250129002158 NV Part B Supplier - Clinic/Group Practice 0143759563 Receives reassigned benefits from 8 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Medical and Behavioral Health Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4225 S Eastern Ave
Ste 8
Las Vegas, NV 89119
Phone (702) 201-1956

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1023721065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 W OWENS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062432",
            "telephone_number": "725-204-0953",
            "fax_number": "702-552-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 S EASTERN AVE STE 8",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195485",
            "telephone_number": "725-204-0953",
            "fax_number": "702-552-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL AND BEHAVIORAL HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A",
        "authorized_official_last_name": "PALABASAN",
        "authorized_official_first_name": "EMILIE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "225-371-1230",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.