American Grace Wellness Center LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

AMERICAN GRACE WELLNESS CENTER LLC

Practice address

3925 N. Martin Luther King Blvd Suite 212
North Las Vegas, NV 89032-7676

Phone

(702) 444-0235

Fax

(702) 992-3505

NPI assigned

Jul 28, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Jacqueline Glasper-Sattwhite, LCSWNPI 1285910075

Title

Ceo/ Clinical Supervisor

Phone

(702) 883-0102

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Glasper-Sattwhite, BS,MBA,LCSW

  • Clinical Social Worker
  • North Las Vegas, NV
  • NPI 1285910075
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1831574136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 N. MARTIN LUTHER KING BLVD SUITE 212",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890327676",
            "telephone_number": "702-444-0235",
            "fax_number": "702-992-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 N. MARTIN LUTHER KING BLVD SUITE 212",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890327676",
            "telephone_number": "702-444-0235",
            "fax_number": "702-992-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN GRACE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "GLASPER-SATTWHITE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CEO/ CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "702-883-0102",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE BOARD OF EXAMINERS FOR SOCIAL WORKERS",
            "identifier": "9028-C",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "behavioralhealth@amgracewellness.org",
            "affiliation": "N",
            "address_1": "3925 N. Martin Luther King Blvd Suite 212",
            "city": "North Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890327676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Behavioral Health Agency in North Las Vegas, NV
• Providers in North 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 Nov 10, 2022; 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.