NPIMap

Organization Active NPI

NV St DV MH DS So NV Mr SVCS

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Las Vegas, NV
National Provider Identifier
1760544969
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
698IMR-16 Issued in NV
Legal business name
NV ST DV MH DS SO NV MR SVCS
Practice address
1391 S Jones Blvd
Las Vegas, NV 89146-1200
Phone
(702) 486-6200
Fax
(702) 486-6368
NPI assigned
Dec 14, 2006
Last updated
Feb 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Authorized official

Name
Michelle L. Ashcraft
Title
Admin Service Officer III
Phone
(775) 687-0511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 698IMR-16 NV Primary

Addresses

Primary practice location

1391 S Jones Blvd
Las Vegas, NV 89146-1200

Mailing address

1391 S Jones Blvd
Las Vegas, NV 89146-1200
Phone (702) 486-6200

Other identifiers 1

IdentifierTypeStateIssuer
005402091MedicaidNV

Other names 1

  • Desert Regional Center Other name

National Provider Directory

National Provider Directory
Tax ID family
State of Nevada Bureau125 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1760544969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461200",
            "telephone_number": "702-486-6200",
            "fax_number": "702-486-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1391 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461200",
            "telephone_number": "702-486-6200",
            "fax_number": "702-486-6368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NV ST DV MH DS SO NV MR SVCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "ASHCRAFT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "ADMIN SERVICE OFFICER III",
        "authorized_official_telephone_number": "775-687-0511"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NV",
            "license": "698IMR-16",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005402091",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Regional Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Desert Regional Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 3, 2021; 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.