Golden Road Behavioral Health SVC LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GOLDEN ROAD BEHAVIORAL HEALTH SVC LLC

Practice address

1700 E Desert Inn Rd Ste 304B
Las Vegas, NV 89169-3207

Phone

(702) 265-1112

Fax

(702) 442-8469

NPI assigned

Oct 16, 2018

Last updated

Oct 16, 2018By 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

Malkia A Lockett

Title

MGR/MGR

Phone

(702) 265-1112

Specialties & licenses 1

Addresses

Tax ID family

Golden Road Behavioral Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Golden Road Behavioral Health SVC LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1013497452
  NPD tax ID

Locations

Practitioners 1

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.

• Ayasha Shamsud-Din

  • Mental Health Counselor
  • Las Vegas, NV
  • NPI 1124593546
  NPD (past)

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539648000000",
    "number": "1770059891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E DESERT INN RD STE 304B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693207",
            "telephone_number": "702-265-1112",
            "fax_number": "702-442-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E DESERT INN RD STE 304B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693207",
            "telephone_number": "702-265-1112",
            "fax_number": "702-442-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN ROAD BEHAVIORAL HEALTH SVC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A",
        "authorized_official_last_name": "LOCKETT",
        "authorized_official_first_name": "MALKIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MGR/MGR",
        "authorized_official_telephone_number": "702-265-1112"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Home Care L.L.C.
• Golden Lake Care Home (maide llc)
• Golden Life
• Golden Miles
• Golden Road Behavioral Health SVC LLC
• Golden Soul Psychotherapy and Wellness
• Golden Sunshine Alzheimer's Home Care, Inc. (CNC Alzheimer's Home Care)
• Golden Sunshine Alzheimers Care (Summerlin Retirement Home)
• Golden Therapy Solutions LLC
• Golden Touch ABA NV, LLC

• 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 16, 2018; 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.