Fort Peace

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FORT PEACE

Practice address

7121 W Craig Rd Ste 113
Unit 148
Las Vegas, NV 89129-6023

Phone

(702) 546-9431

NPI assigned

Feb 2, 2015

Organization subpart

Yes

Parent organization

ROSE OF SHARONAs reported in NPPES

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

Authorized official

Name

Willie J Frink III, BISHOP

Title

Ceo

Phone

(702) 546-9431

Specialties & licenses 1

Addresses

Part of

Fort Peace

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1285024968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7121 W CRAIG RD STE 113",
            "address_2": "UNIT 148",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296023",
            "telephone_number": "702-546-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7121 W CRAIG RD STE 113",
            "address_2": "UNIT 148",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296023",
            "telephone_number": "702-546-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT PEACE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROSE OF SHARON",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "FRINK",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-546-9431",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "BISHOP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.