NPIMap

Organization Active NPI

Impact Behavioral Health, Inc

  • Community/Behavioral Health Agency
  • Las Vegas, NV
National Provider Identifier
1770846545
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
IMPACT BEHAVIORAL HEALTH, INC
Practice address
8301 Boseck Dr Unit 229
Las Vegas, NV 89145-4558
Phone
(702) 858-7086
NPI assigned
Jun 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Authorized official

Name
Carolyn Pridgeon
Title
Exceutive Director
Phone
(702) 858-7086

Specialties & licenses 1

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

Addresses

Primary practice location

8301 Boseck Dr Unit 229
Las Vegas, NV 89145-4558

Mailing address

8301 Boseck Dr Unit 229
Las Vegas, NV 89145-4558
Phone (702) 858-7086

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1770846545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 BOSECK DR UNIT 229",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454558",
            "telephone_number": "702-858-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 BOSECK DR UNIT 229",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454558",
            "telephone_number": "702-858-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT BEHAVIORAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "PRIDGEON",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "EXCEUTIVE DIRECTOR",
        "authorized_official_telephone_number": "702-858-7086"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 18, 2012; 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.