NPIMap

Organization Active NPI

Nevada Integrated Behavioral Services Inc.

Doing business as Nevada Treatment Center

  • Methadone Clinic
  • Las Vegas, NV
National Provider Identifier
1932575156
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
8352NTC-0 Issued in NV
Legal business name
NEVADA INTEGRATED BEHAVIORAL SERVICES INC.
Doing business as
Nevada Treatment Center
Practice address
1721 E Charleston Blvd
Las Vegas, NV 89104-1902
Phone
(702) 685-0620
Fax
(702) 685-9674
NPI assigned
Aug 12, 2015
Last updated
Aug 12, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
NEVADA INTEGRATED BEHAVIORAL SERVICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Authorized official

Name
Mr. Festus Ebonka Ebonka, APRN
Title
Program Director
Phone
(702) 515-9680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 8352NTC-0 NV Primary

Addresses

Primary practice location

1721 E Charleston Blvd
Las Vegas, NV 89104-1902

Mailing address

1721 E Charleston Blvd
Las Vegas, NV 89104-1902
Phone (702) 685-0620

Other names 1

  • Nevada Treatment Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nevada Integrated Behavioral Services Inc3 organizations share this tax ID, including this one
Part of
Nevada Integrated Behavioral Services Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439337600000",
    "number": "1932575156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041902",
            "telephone_number": "702-685-0620",
            "fax_number": "702-685-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041902",
            "telephone_number": "702-685-0620",
            "fax_number": "702-685-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA INTEGRATED BEHAVIORAL SERVICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEVADA INTEGRATED BEHAVIORAL SERVICES INC.",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A",
        "authorized_official_last_name": "EBONKA",
        "authorized_official_first_name": "FESTUS EBONKA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "702-515-9680",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NV",
            "license": "8352NTC-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nevada Treatment Center",
            "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 12, 2015; 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.