P Saint Roc LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

P SAINT ROC LLC

Practice address

1700 Alta Dr Apt 2124
Las Vegas, NV 89106-4174

Phone

(702) 465-6794

NPI assigned

Sep 21, 2020

Organization subpart

No

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

Authorized official

Name

Ikechukwuka Peter Onwuka-Smarty

Title

Manager

Phone

(702) 465-6794

Specialties & licenses 1

Addresses

Other names 1

• P SAINT ROC WELLNESS CENTER Doing business as

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1295341733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 ALTA DR APT 2124",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064174",
            "telephone_number": "702-465-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 ALTA DR APT 2124",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064174",
            "telephone_number": "702-465-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P SAINT ROC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "ONWUKA-SMARTY",
        "authorized_official_first_name": "IKECHUKWUKA",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-465-6794"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P SAINT ROC WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 Sep 21, 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.