NPIMap

Organization Active NPI

Mobile Mental Health Support Services, Inc.

  • Physical Disabilities Residential Treatment Facility
  • Las Vegas, NV
National Provider Identifier
1871734772
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
Legal business name
MOBILE MENTAL HEALTH SUPPORT SERVICES, INC.
Practice address
5348 Hanging Tree LN
Las Vegas, NV 89118-2032
Phone
(702) 556-1511
NPI assigned
Mar 23, 2009
Last updated
Mar 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Authorized official

Name
Tanitsha K. Bridgers, MSW
Title
Clinical Administrator
Phone
(702) 556-1511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X NV Primary

Addresses

Primary practice location

5348 Hanging Tree LN
Las Vegas, NV 89118-2032

Mailing address

5348 Hanging Tree LN
Las Vegas, NV 89118-2032
Phone (702) 556-1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090616000064 NV Part B Supplier - Clinic/Group Practice 6103976089 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Mobile Mental Health Support Services Inc2 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.

Locations

3085 S Jones Blvd
Ste D
Las Vegas, NV 89146
Phone (702) 888-0036

Practitioners & affiliated clinicians

Practitioners 56

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.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1871734772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5348 HANGING TREE LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182032",
            "telephone_number": "702-556-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5348 HANGING TREE LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182032",
            "telephone_number": "702-556-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MENTAL HEALTH SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "BRIDGERS",
        "authorized_official_first_name": "TANITSHA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "CLINICAL ADMINISTRATOR",
        "authorized_official_telephone_number": "702-556-1511",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "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 Mar 23, 2009; 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.