Periwinkle Group LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PERIWINKLE GROUP LLC

Doing business as

OTAC Health Managment

Practice address

4270 Cameron St
3A
Las Vegas, NV 89103-7704

Phone

(702) 657-6500

Fax

(702) 664-0502

NPI assigned

Oct 30, 2015

Organization subpart

No

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

Authorized official

Name

Jo Cato

Title

Ceo

Phone

(702) 657-6500

Specialties & licenses 2

Addresses

Other names 1

• OTAC Health Managment Doing business as

Locations

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1477925329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4270 CAMERON ST",
            "address_2": "3A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891037704",
            "telephone_number": "702-657-6500",
            "fax_number": "702-664-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 CAMERON ST",
            "address_2": "3A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891037704",
            "telephone_number": "702-657-6500",
            "fax_number": "702-664-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIWINKLE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "CATO",
        "authorized_official_first_name": "JO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-657-6500"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OTAC Health Managment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Felicidad Perillo
• Kolya D Perine
• Lisa Perine
• Hope Marie Perini
• Tina Perisich
• Ashley A Perkes, RD
• Alexus Perkins
• Alicia Kamya Perkins
• Alisha Marie Perkins
• Amanda Perkins

• 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 Mar 10, 2017; 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.