NPIMap

Organization Active NPI

Southern Nevada Behavioral Health Authority LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
National Provider Identifier
1104221795
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
C201410130539 Issued in NV
Legal business name
SOUTHERN NEVADA BEHAVIORAL HEALTH AUTHORITY LLC
Practice address
1125 Coral Isle Way
Las Vegas, NV 89108-1766
Phone
(702) 419-1262
NPI assigned
Oct 27, 2014
Last updated
Oct 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Authorized official

Name
Mitriece Amelia Sumbry, QMHANPI 1104263755
Title
Owner
Phone
(702) 419-1262

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X C201410130539 NV Primary

Addresses

Primary practice location

1125 Coral Isle Way
Las Vegas, NV 89108-1766

Mailing address

1125 Coral Isle Way
Las Vegas, NV 89108-1766
Phone (702) 419-1262

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1104221795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 CORAL ISLE WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891081766",
            "telephone_number": "702-419-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 CORAL ISLE WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891081766",
            "telephone_number": "702-419-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN NEVADA BEHAVIORAL HEALTH AUTHORITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "SUMBRY",
        "authorized_official_first_name": "MITRIECE",
        "authorized_official_middle_name": "AMELIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-419-1262",
        "authorized_official_credential": "QMHA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": "C201410130539",
            "primary": true
        }
    ],
    "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 Oct 27, 2014; 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.