Organization Active NPI

Home of Possibilities

  • Exclusive Provider Organization
  • Henderson, NV
National Provider Identifier
1114373156
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
Legal business name
HOME OF POSSIBILITIES
Practice address
3370 Saint Rose Pkwy Apt 1428
Henderson, NV 89052-4254
Phone
(702) 979-0224
NPI assigned
May 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Authorized official

Name
Miss Asia Marie Bieniemy
Title
Basic Skills Trainer
Phone
(702) 979-0224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X Primary

Addresses

Primary practice location

3370 Saint Rose Pkwy Apt 1428
Henderson, NV 89052-4254

Mailing address

400 S 4TH St Ste 501
Las Vegas, NV 89101-6201
Phone (702) 979-0224

Other identifiers 1

IdentifierTypeStateIssuer
153499876MedicaidNV

National Provider Directory

National Provider Directory

Locations

400 S 4th St
Ste 501
Las Vegas, NV 89101

NPI Registry JSON

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1114373156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S 4TH ST STE 501",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891016201",
            "telephone_number": "702-979-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3370 SAINT ROSE PKWY APT 1428",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524254",
            "telephone_number": "702-979-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME OF POSSIBILITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "BIENIEMY",
        "authorized_official_first_name": "ASIA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BASIC SKILLS TRAINER",
        "authorized_official_telephone_number": "702-979-0224",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153499876",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.