Advanced Behavioral and Mental Healthcare Services, Inc.
Organization Active NPI Community/Behavioral Health Agency · Las Vegas, NV
NPI 1104313477 · NPPES record last updated Mar 19, 2021
Key facts
- NPI
- 1104313477
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- ADVANCED BEHAVIORAL AND MENTAL HEALTHCARE SERVICES, INC.
- Practice address
- 8120 Dolce Flore Ave
Las Vegas, NV 89178-8270 - Phone
- (702) 285-1185
- Fax
- (702) 270-9763
- NPI assigned
- Apr 22, 2018
- Organization subpart
- No
Authorized official
- Name
- Lorelly P Gumpal
- Title
- President
- Phone
- (702) 285-1185
Corporate family (same tax ID) 1
Practitioners 7
-
Teodora Del Pilar, APRN
-
Zelluyah W Gaitho, APN
-
Deidre Jenkins, LMFT
-
David Patrick Gennis, PSY.D., LMFT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200115000035 | NV | Part B Supplier - Clinic/Group Practice | 3476988783 |
Receives reassigned benefits from 5 practitioners Practice locations: Las Vegas, NV |
National Provider Directory
- Tax ID family
- Advanced Behavioral and Mental Healthcare Services Inc
Locations
855 E Twain Ave
Ste 106
Las Vegas, NV 89169
Phone (702) 937-0790
2801 S Valley View Blvd
Ste 1C
Las Vegas, NV 89102
Phone (725) 263-6707
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | NV | Yes |
Addresses
Primary practice location
8120 Dolce Flore Ave
Las Vegas, NV 89178-8270
Mailing address
8120 Dolce Flore Ave
Las Vegas, NV 89178-8270
Phone (702) 285-1185
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All providers in Las Vegas, NV · Community/Behavioral Health Agency in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.