Organization Active NPI

Renewed Mind Wellness Center

  • Adult Mental Health Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1275069247
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
RENEWED MIND WELLNESS CENTER
Practice address
4170 S Decatur Blvd
Las Vegas, NV 89103-5861
Phone
(702) 497-6187
Fax
(702) 993-3957
NPI assigned
May 11, 2017
Last updated
Aug 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Authorized official

Name
Christopher Usigbe
Title
President
Phone
(702) 497-6187

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

4170 S Decatur Blvd
Las Vegas, NV 89103-5861

Mailing address

4170 S Decatur Blvd
Las Vegas, NV 89103-5861
Phone (702) 504-7292

Other practice location 1

117 Rosa Rosales Ct
N Las Vegas, NV 89031-2593
Phone (702) 497-6187

Other practice location 2

5715 W Alexander Rd Ste 110
Las Vegas, NV 89130-2815
Phone (702) 333-4373

National Provider Directory

National Provider Directory

Locations

4170 S Decatur Blvd
Las Vegas, NV 89103
Phone (702) 497-6187

4170 S Decatur Blvd
Ste A8
Las Vegas, NV 89103

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1275069247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 S DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035861",
            "telephone_number": "702-504-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4170 S DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035861",
            "telephone_number": "702-497-6187",
            "fax_number": "702-993-3957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Rosa Rosales Ct",
            "address_purpose": "LOCATION",
            "city": "N Las Vegas",
            "state": "NV",
            "postal_code": "890312593",
            "country_code": "US",
            "telephone_number": "702-497-6187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5715 W Alexander Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891302815",
            "country_code": "US",
            "telephone_number": "702-333-4373",
            "fax_number": "702-333-4337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RENEWED MIND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "USIGBE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-497-6187"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "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 Aug 17, 2020; 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.