NPIMap

Organization Active NPI

Fundamental Behavioral Services LLC

Doing business as Nevada Behavioral Health Systems

  • Community/Behavioral Health Agency
  • Las Vegas, NV
National Provider Identifier
1699158600
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FUNDAMENTAL BEHAVIORAL SERVICES LLC
Doing business as
Nevada Behavioral Health Systems
Practice address
3035 S. Maryland Parkway
Suite 110
Las Vegas, NV 89109
Phone
(702) 978-8100
Fax
(702) 857-8801
NPI assigned
Jul 8, 2015
Last updated
Mar 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Authorized official

Name
Abby Grossa
Title
Cfo
Phone
(702) 338-8373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

3035 S. Maryland Parkway
Suite 110
Las Vegas, NV 89109

Mailing address

2921 N. Tenaya Way
Las Vegas, NV 89128-0454
Phone (702) 683-2591

Other names 1

  • Nevada Behavioral Health Systems Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210329000558 NV Part B Supplier - Clinic/Group Practice 0345657979 Receives reassigned benefits from 34 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

3035 S Maryland Pkwy
Ste 110
Las Vegas, NV 89109
Phone (702) 751-2547

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1699158600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 N. TENAYA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280454",
            "telephone_number": "702-683-2591",
            "fax_number": "702-645-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 S. MARYLAND PARKWAY",
            "address_2": "SUITE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89109",
            "telephone_number": "702-978-8100",
            "fax_number": "702-857-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTAL BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "GROSSA",
        "authorized_official_first_name": "ABBY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "702-338-8373"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nevada Behavioral Health Systems",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nevada Behavioral Health Systems",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.