NPIMap

Organization Active NPI

Child and Adolescent Mental Health Psychiatric Services

  • Community/Behavioral Health Agency
  • Sparks, NV
National Provider Identifier
1437565744
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
E0133382012-2 Issued in NV
Legal business name
CHILD AND ADOLESCENT MENTAL HEALTH PSYCHIATRIC SERVICES
Practice address
1055 Roberta LN
Sparks, NV 89431-2809
Phone
(775) 331-8747
NPI assigned
Jul 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Authorized official

Name
Mrs. Tanja Ford
Title
Program Director
Phone
(775) 331-8747

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X E0133382012-2 NV
Community/Behavioral Health Agency 251S00000X E0133382012-2 NV Primary
Early Intervention Provider Agency 252Y00000X E0133382012-2 NV
In Home Supportive Care Agency 253Z00000X E0133382012-2 NV

Addresses

Primary practice location

1055 Roberta LN
Sparks, NV 89431-2809

Mailing address

1055 Roberta LN
Sparks, NV 89431-2809

Other identifiers 1

IdentifierTypeStateIssuer
E0133382012-2MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
Child and Adolescent Mental Health Psychiatric Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1055 Roberta Ln
Sparks, NV 89431
Phone (775) 331-8747

NPI Registry JSON

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1437565744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 ROBERTA LN",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894312809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 ROBERTA LN",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894312809",
            "telephone_number": "775-331-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD AND ADOLESCENT MENTAL HEALTH PSYCHIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2014-07-08",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "TANJA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "775-331-8747",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NV",
            "license": "E0133382012-2",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": "E0133382012-2",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NV",
            "license": "E0133382012-2",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NV",
            "license": "E0133382012-2",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E0133382012-2",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.