Outward Bound

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

OUTWARD BOUND

Practice address

6130 Elton Ave
Las Vegas, NV 89107-2538

Phone

(336) 697-9310

Fax

(336) 510-0928

NPI assigned

May 25, 2012

Last updated

May 25, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Trishonda Patrick

Title

President

Phone

(336) 558-6171

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1518227370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 ELTON AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072538",
            "telephone_number": "336-697-9310",
            "fax_number": "336-510-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 ELTON AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072538",
            "telephone_number": "336-697-9310",
            "fax_number": "336-510-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTWARD BOUND",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "TRISHONDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-558-6171"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "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 May 25, 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.