Passport to Independence LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

PASSPORT TO INDEPENDENCE LLC

Practice address

580 W Cheyenne Ave Ste 40
North Las Vegas, NV 89030-3978

Phone

(702) 462-6692

NPI assigned

Apr 27, 2017

Organization subpart

No

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

Authorized official

Name

Denise ColesNPI 1164957056

Title

Manager

Phone

(702) 504-5020

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Denise Coles

  • Behavior Analyst
  • Las Vegas, NV
  • NPI 1164957056
  NPD (past) Authorized official

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1891220786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 W CHEYENNE AVE STE 40",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890303978",
            "telephone_number": "702-462-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W CHEYENNE AVE STE 40",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890303978",
            "telephone_number": "702-462-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSPORT TO INDEPENDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "COLES",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-504-5020"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adriana Pasillas
• Richard Andrew Pass Jr., OTD, OTR/L
• Cristina Passalacqua
• Pedro Gino Passalacqua
• Passion Medical Associates Inc
• Michael Gene Patane
• Debra J Pate, M.S., C.T.R.S.
• Arbaaz Patel
• Bhavin Patel, D.M.D
• Dhruv Patel

• Mental Illness Community Based Residential Treatment Facility in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Mental Illness Community Based Residential Treatment Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.