Active NPI
Raiseup Community Development Corporation
- Community/Behavioral Health Agency
- Las Vegas, NV
National Provider Identifier
1841570082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 5909-C
- Legal business name
- RAISEUP COMMUNITY DEVELOPMENT CORPORATION
- Doing business as
- RaiseUp Life Management Services
- Practice address
- 5328 Vista Hermosa Ave
Las Vegas, NV 89108-4095 - Phone
- (702) 592-4814
- Fax
- (702) 631-9475
- NPI assigned
- Aug 19, 2011
- Organization subpart
- Yes
- Parent organization
- RAISEUP COMMUNITY DEVELOPMENT CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Anthony Fitzgerald Harris, LCSW, LADC
- Title
- President
- Phone
- (702) 592-4814
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | 4913-S | NV | |
| Community/Behavioral Health Agency | 251S00000X | 5909-C | NV | Primary |
Addresses
Primary practice location
5328 Vista Hermosa Ave
Las Vegas, NV 89108-4095
Mailing address
5328 Vista Hermosa Ave
Las Vegas, NV 89108-4095
Phone (702) 592-4814
Other names 1
- RaiseUp Life Management Services
National Provider Directory
National Provider Directory- Part of
- Raiseup Community Development Corporation
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Community/Behavioral Health Agency
- Las Vegas, NV
- NPI 1255622353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313712000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1313712000000",
"number": "1841570082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5328 VISTA HERMOSA AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891084095",
"telephone_number": "702-592-4814",
"fax_number": "702-631-9475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5328 VISTA HERMOSA AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891084095",
"telephone_number": "702-592-4814",
"fax_number": "702-631-9475"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RAISEUP COMMUNITY DEVELOPMENT CORPORATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "RAISEUP COMMUNITY DEVELOPMENT CORPORATION",
"enumeration_date": "2011-08-19",
"last_updated": "2011-08-19",
"status": "A",
"authorized_official_last_name": "HARRIS",
"authorized_official_first_name": "ANTHONY",
"authorized_official_middle_name": "FITZGERALD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "702-592-4814",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "LCSW, LADC"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "NV",
"license": "4913-S",
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NV",
"license": "5909-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "RaiseUp Life Management Services",
"code": "3",
"type": "Doing Business As"
}
]
}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 Aug 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.