NPIMap

Organization Active NPI

Serenity Community Care and Behavioral Health

  • Community/Behavioral Health Agency
  • North Las Vegas, NV
National Provider Identifier
1063794626
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SERENITY COMMUNITY CARE AND BEHAVIORAL HEALTH
Practice address
2039 E Lake Mead Blvd
North Las Vegas, NV 89030-7135
Phone
(702) 724-9300
NPI assigned
Sep 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Authorized official

Name
Mr. Eugene Ahmad Wallace
Title
Owner
Phone
(702) 326-2529

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2039 E Lake Mead Blvd
North Las Vegas, NV 89030-7135

Mailing address

2039 E Lake Mead Blvd
North Las Vegas, NV 89030-7135
Phone (702) 724-9300

National Provider Directory

National Provider Directory

Locations

2039 E Lake Mead Blvd
North Las Vegas, NV 89030
Phone (702) 724-9300

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1063794626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307135",
            "telephone_number": "702-724-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307135",
            "telephone_number": "702-724-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY COMMUNITY CARE AND BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-09",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "AHMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-326-2529",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.