NPIMap

Organization Active NPI

Transformation360 LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
National Provider Identifier
1144720657
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
TRANSFORMATION360 LLC
Practice address
5025 Hostetler Ave
Las Vegas, NV 89131-1981
Phone
(702) 969-5970
NPI assigned
Feb 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Authorized official

Name
Alice Delia Peterson
Title
Owner
Phone
(702) 969-5970

Specialties & licenses 1

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

Addresses

Primary practice location

5025 Hostetler Ave
Las Vegas, NV 89131-1981

Mailing address

5025 Hostetler Ave
Las Vegas, NV 89131-1981
Phone (702) 969-5970

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.

NPI Registry JSON

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519084800000",
    "number": "1144720657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5025 HOSTETLER AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891311981",
            "telephone_number": "702-969-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 HOSTETLER AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891311981",
            "telephone_number": "702-969-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATION360 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "DELIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-969-5970"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "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 Feb 20, 2018; 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.