NPIMap

Organization Active NPI

R.E.S.T.O.R.E. Behavioral Health Rehabilitative Treatment Services,LLC

  • Behavior Analyst
  • North Las Vegas, NV
National Provider Identifier
1386923506
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
20111522035 Issued in NV
Legal business name
R.E.S.T.O.R.E. BEHAVIORAL HEALTH REHABILITATIVE TREATMENT SERVICES,LLC
Practice address
3925 North Martin Luther King Blvd.
Suite 215
North Las Vegas, NV 89032-7676
Phone
(404) 449-3463
Fax
(702) 990-2063
NPI assigned
Aug 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Authorized official

Name
Ms. Rita Michelle Blankenship, MS, CADC-INPI 1174810428
Title
Executive Director/Ceo
Phone
(404) 449-3463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 20111522035 NV Primary

Addresses

Primary practice location

3925 North Martin Luther King Blvd.
Suite 215
North Las Vegas, NV 89032-7676

Mailing address

3925 North Martin Luther King Blvd.
Suite 215
North Las Vegas, NV 89032-7676
Phone (404) 449-3463

Other identifiers 1

IdentifierTypeStateIssuer
1386923506MedicaidNV

National Provider Directory

National Provider Directory

Locations

3925 N Martin L King Blvd
Ste 215
North Las Vegas, NV 89032
Phone (404) 449-3463

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405296000000",
    "number": "1386923506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 NORTH MARTIN LUTHER KING BLVD.",
            "address_2": "SUITE 215",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890327676",
            "telephone_number": "404-449-3463",
            "fax_number": "702-990-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 NORTH MARTIN LUTHER KING BLVD.",
            "address_2": "SUITE 215",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890327676",
            "telephone_number": "404-449-3463",
            "fax_number": "702-990-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R.E.S.T.O.R.E. BEHAVIORAL HEALTH REHABILITATIVE TREATMENT SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-04",
        "last_updated": "2014-07-14",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
        "authorized_official_telephone_number": "404-449-3463",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, CADC-I"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "20111522035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386923506",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.