NPIMap

Organization Active NPI

Fayth Wellness Center LLC

  • Community/Behavioral Health Agency
  • Henderson, NV
National Provider Identifier
1245673870
Registry record updated Apr 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
NV20121626665 Issued in NV
Legal business name
FAYTH WELLNESS CENTER LLC
Practice address
913 Crescent Falls St
Henderson, NV 89011-2516
Phone
(702) 340-6736
NPI assigned
Apr 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2013

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

Authorized official

Name
Tyneshia BrooksNPI 1679838635
Title
Ceo/Director
Phone
(702) 340-6736

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NV20121626665 NV Primary

Addresses

Primary practice location

913 Crescent Falls St
Henderson, NV 89011-2516

Mailing address

913 Crescent Falls St
Henderson, NV 89011-2516

Other names 1

  • Family, Adult, Youth, Theapeutic, Healing Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1365811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365811200000",
    "number": "1245673870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 CRESCENT FALLS ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890112516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 CRESCENT FALLS ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890112516",
            "telephone_number": "702-340-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYTH WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-13",
        "last_updated": "2013-04-13",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "TYNESHIA",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "702-340-6736"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": "NV20121626665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family, Adult, Youth, Theapeutic, Healing",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 13, 2013; 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.