St. Andrew Care Home

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

4309AGC10 Issued in NV

Legal business name

ST. ANDREW CARE HOME

Practice address

1168 E Hacienda Ave
Las Vegas, NV 89119-1814

Phone

(702) 736-2161

Fax

(702) 736-4714

NPI assigned

Jul 2, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Evangeline Brigino CruzNPI 1669737813

Title

Owner

Phone

(702) 480-4858

Specialties & licenses 1

Addresses

Practitioners 2

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

• Evangeline Brigino Cruz

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1669737813
  NPD (past) Authorized official
• Melanie Brigino Cruz

  • Behavior Analyst
  • Las Vegas, NV
  • NPI 1225378557
  NPD (past)

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1407110794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1168 E HACIENDA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891191814",
            "telephone_number": "702-736-2161",
            "fax_number": "702-736-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1168 E HACIENDA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891191814",
            "telephone_number": "702-736-2161",
            "fax_number": "702-736-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANDREW CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "EVANGELINE",
        "authorized_official_middle_name": "BRIGINO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-480-4858",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": "4309AGC10",
            "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 Jul 2, 2012; 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.