NPIMap

Organization Active NPI

Ignite Teen Treatment, LLC

  • Psychiatric Residential Treatment Facility
  • Las Vegas, NV
National Provider Identifier
1316551682
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
IGNITE TEEN TREATMENT, LLC
Practice address
2761 Family CT
Las Vegas, NV 89117-2601
Phone
(866) 604-7273
NPI assigned
Sep 3, 2020
Last updated
Nov 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Authorized official

Name
Melissa Marshall
Title
Director of Billing & Collections
Phone
(570) 203-9222

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Psychiatric Residential Treatment Facility 323P00000X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

2761 Family CT
Las Vegas, NV 89117-2601

Mailing address

512 Northampton St # 158
Edwardsville, PA 18704-4560
Phone (570) 203-9222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316551682. Details of each certification follow.

  • CCN 29L005 Psychiatric residential treatment facility · Active · Name & address match · Details

Psychiatric residential treatment facility certification: CCN 29L005

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
IGNITE TEEN TREATMENT - FAMILY CT
Certification status
Active
Provider type (POS)
Psychiatric residential treatment facility
Participating since
Jul 10, 2024
Last certification
Jul 10, 2024
Beds
10
Ownership / control type
Government – state
Facility address
2761 Family CT
Las Vegas, NV 89117

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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1316551682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 NORTHAMPTON ST # 158",
            "city": "EDWARDSVILLE",
            "state": "PA",
            "postal_code": "187044560",
            "telephone_number": "570-203-9222",
            "fax_number": "570-203-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2761 FAMILY CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172601",
            "telephone_number": "866-604-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE TEEN TREATMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING & COLLECTIONS",
        "authorized_official_telephone_number": "570-203-9222"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "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": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.