NPIMap

Organization Active NPI

Ignite Teen Treatment, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1265142186
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
IGNITE TEEN TREATMENT, LLC
Practice address
2330 Paseo del Prado Ste C103
Las Vegas, NV 89102-4336
Phone
(725) 272-0330
NPI assigned
Dec 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Teresa M Potter
Title
Director of Compliance
Phone
(725) 272-0330

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

2330 Paseo del Prado Ste C103
Las Vegas, NV 89102-4336

Mailing address

8635 W Sahara Ave # 10
Las Vegas, NV 89117-5858
Phone (725) 272-0330

Other names 1

  • Sahara OP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ignite Teen Treatment LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1265142186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 W SAHARA AVE # 10",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175858",
            "telephone_number": "725-272-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 PASEO DEL PRADO STE C103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891024336",
            "telephone_number": "725-272-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE TEEN TREATMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "725-272-0330"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sahara OP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 1, 2022; 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.