M.O.M.S Community Development Corporation

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

M.O.M.S COMMUNITY DEVELOPMENT CORPORATION

Doing business as

M.O.M.S COMMUNITY DEVELOPMENT CORPORATION

Practice address

3620 N Rancho Dr Ste 111
Las Vegas, NV 89130-3154

Phone

(702) 639-4400

Fax

(702) 639-4403

NPI assigned

May 27, 2011

Organization subpart

No

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

Authorized official

Name

Phyllis Tellis

Title

President

Phone

(702) 639-4400

Specialties & licenses 1

Addresses

Other names 1

• M.O.M.S COMMUNITY DEVELOPMENT CORPORATION Doing business as

Locations

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1871886507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 N RANCHO DR STE 111",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303154",
            "telephone_number": "702-639-4400",
            "fax_number": "702-639-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 N RANCHO DR STE 111",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303154",
            "telephone_number": "702-639-4400",
            "fax_number": "702-639-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.O.M.S COMMUNITY DEVELOPMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-27",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "TELLIS",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-639-4400"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M.O.M.S COMMUNITY DEVELOPMENT CORPORATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.