Waterfall Behavioral Health Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

NV20181152974 Issued in NV

Legal business name

WATERFALL BEHAVIORAL HEALTH SERVICES

Practice address

4760 S Pecos Rd Ste 103-19
Las Vegas, NV 89121-6038

Phone

(702) 207-1005

NPI assigned

Mar 1, 2018

Last updated

Jun 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Martha MoqueteNPI 1437969003

Title

Administrator/Owner

Phone

(702) 929-6316

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WATERFALL BEHAVIORAL HEALTH SERVICES Former legal business name

Locations

Practitioners 1

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.

• Martha Moquete

  • Case Manager/Care Coordinator
  • Las Vegas, NV
  • NPI 1437969003
  NPD Authorized official

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1881196277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 S PECOS RD STE 103-19",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891216038",
            "telephone_number": "702-207-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 S PECOS RD STE 103-19",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891216038",
            "telephone_number": "702-207-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFALL BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "MOQUETE",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "702-929-6316"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": "NV20181152974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538530514",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WATERFALL BEHAVIORAL HEALTH SERVICES",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in 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 Jun 16, 2018; 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.