NPIMap

Organization Active NPI

Pro-Health Therapeutic & Empowerment Services LLC

  • General Practice Physician
  • Las Vegas, NV
National Provider Identifier
1053967265
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PRO-HEALTH THERAPEUTIC & EMPOWERMENT SERVICES LLC
Practice address
3235 S Eastern Ave
Las Vegas, NV 89169-3310
Phone
(702) 490-9009
Fax
(866) 737-6147
NPI assigned
Aug 13, 2019
Organization subpart
Yes
Parent organization
PROHEALTH THERAPEUTIC & EMPOWERMENT SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Authorized official

Name
Keisha GrahamNPI 1063780500
Title
Managing Director
Phone
(702) 490-9009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3235 S Eastern Ave
Las Vegas, NV 89169-3310

Mailing address

3235 S Eastern Ave
Las Vegas, NV 89169-3310
Phone (702) 490-9009

Other names 1

  • ProHealth Therapeutic & Empowerment Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pro-Health Therapeutic Emp4 organizations share this tax ID, including this one
Part of
Pro-Health Therapeutic Emp

Other organizations with this tax ID 3

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

Locations

3235 S Eastern Ave
Las Vegas, NV 89169
Phone (702) 894-9880

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1053967265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693310",
            "telephone_number": "702-490-9009",
            "fax_number": "866-737-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693310",
            "telephone_number": "702-490-9009",
            "fax_number": "866-737-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-HEALTH THERAPEUTIC & EMPOWERMENT SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROHEALTH THERAPEUTIC & EMPOWERMENT SERVICES LLC",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "702-490-9009"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProHealth Therapeutic & Empowerment Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 13, 2019; 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.