Supportive Outreach Services Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SUPPORTIVE OUTREACH SERVICES INC.

Practice address

6117 Glenborough St
Las Vegas, NV 89115-6017

Phone

(702) 807-1333

NPI assigned

Oct 7, 2013

Organization subpart

No

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

Authorized official

Name

Niesha Allen

Title

President

Phone

(702) 807-1333

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1381104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381104000000",
    "number": "1720415672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6117 GLENBOROUGH ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891156017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6117 GLENBOROUGH ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891156017",
            "telephone_number": "702-807-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE OUTREACH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-07",
        "last_updated": "2013-10-07",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "NIESHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-807-1333"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Supplemental Healthcare (SHC)
• Supported Living Solutions
• Supportive and Behavioral Counseling of Las Vegas, LLC
• Supportive Counseling Services LLC
• Supportive Counseling, LLC
• Supreme Behavioral Health Services L.L.C.
• Supreme Dental
• Surbhi Surana
• Teja Venkatahara Surapaneni, M.D.
• Suresh G Prabhu MD PC

• 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 Oct 7, 2013; 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.