Everton's Place LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EVERTON'S PLACE LLC

Doing business as

IMpossible Mental Health Services

Practice address

1333 N Buffalo Dr Unit 250
Las Vegas, NV 89128-3637

Phone

(702) 507-0373

NPI assigned

Aug 9, 2019

Last updated

Dec 2, 2021By 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

Terrell DrakeNPI 1194483537

Title

Coo/Director of Operations

Phone

(702) 622-2679

Specialties & licenses 1

Addresses

Other names 1

• IMpossible Mental Health Services Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Terrell Anthony Drake

  • Behavior Technician
  • Las Vegas, NV
  • NPI 1194483537
  NPD Authorized official
• Dexter Anthony Drake

  • Behavior Technician
  • Las Vegas, NV
  • NPI 1053079400
  NPD

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1518513142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10166 SKYE SADDLE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891666597",
            "telephone_number": "702-507-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 N BUFFALO DR UNIT 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891283637",
            "telephone_number": "702-507-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERTON'S PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-09",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "TERRELL",
        "authorized_official_title_or_position": "COO/DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "702-622-2679"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMpossible Mental Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IMpossible Mental Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Everside Health, LLC
• Brandy Eversole
• Gaylin L. Everson
• Lisa Marie Evert, LCSW
• Everton's Place II, Inc (IMpossible Behavioral Health)
• Everwell Internal Medicine PLLC
• Everwell Medical LLC
• Everyday Miracles
• Everyday Miracles LLC
• Everyday Miracles LLC (Everyday Miracles)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.