NPIMap

Organization Active NPI

Nevada Family Practice Residency Program, Inc.

Doing business as Mojave Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Las Vegas, NV
National Provider Identifier
1407051717
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
NEVADA FAMILY PRACTICE RESIDENCY PROGRAM, INC.
Doing business as
Mojave Mental Health
Practice address
4000 E Charleston Blvd
Suite 230
Las Vegas, NV 89104-6659
Phone
(702) 968-5059
Fax
(702) 968-4041
NPI assigned
Jun 18, 2007
Last updated
Jun 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
James R Parcells, LISW
Title
President
Phone
(702) 968-5059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NV Primary

Addresses

Primary practice location

4000 E Charleston Blvd
Suite 230
Las Vegas, NV 89104-6659

Mailing address

4000 E Charleston Blvd
Suite 230
Las Vegas, NV 89104-6659
Phone (702) 968-5059

Other identifiers 1

IdentifierTypeStateIssuer
005402100MedicaidNV

Other names 1

  • Mojave Mental Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
N F P R P Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1407051717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 E CHARLESTON BLVD",
            "address_2": "SUITE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891046659",
            "telephone_number": "702-968-5059",
            "fax_number": "702-968-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 E CHARLESTON BLVD",
            "address_2": "SUITE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891046659",
            "telephone_number": "702-968-5059",
            "fax_number": "702-968-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA FAMILY PRACTICE RESIDENCY PROGRAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "PARCELLS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-968-5059",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005402100",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mojave Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 17, 2008; 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.