Committed 100 Men Helping Boys

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COMMITTED 100 MEN HELPING BOYS

Doing business as

Rising Stars Behavioral Health

Practice address

4550 W Oakey Blvd
Suite 104a
Las Vegas, NV 89102-1581

Phone

(702) 462-0316

Fax

(702) 462-0317

NPI assigned

Jul 23, 2016

Organization subpart

No

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

Authorized official

Name

Mike Waller

Title

President

Phone

(702) 462-0316

Specialties & licenses 1

Addresses

Other names 1

• Rising Stars Behavioral Health Doing business as

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

{
    "created_epoch": "1469232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469232000000",
    "number": "1073966206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 W OAKEY BLVD",
            "address_2": "SUITE 104A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021581",
            "telephone_number": "702-462-0316",
            "fax_number": "702-462-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 W OAKEY BLVD",
            "address_2": "SUITE 104A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021581",
            "telephone_number": "702-462-0316",
            "fax_number": "702-462-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMITTED 100 MEN HELPING BOYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-23",
        "last_updated": "2016-07-23",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-462-0316"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rising Stars Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nohrelynn Sejalbo Comia
• Pualani Cominella
• Deanna Comish
• Delia Marcos Comiso
• Josephine Comiso
• Tasha Commodore
• Communidad Hispana Counseling Services, LLC
• Communities in Schools of Nevad (Future Smiles)
• Community Access Network LLC
• Community Alliance Network and Development Outreach

• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2016; 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.