New Vanatge LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NEW VANATGE LLC

Practice address

9781 Dottie Jewel Ave
Las Vegas, NV 89147-6766

Phone

(313) 212-6733

NPI assigned

May 31, 2013

Last updated

May 31, 2013By 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

Nathanian Richbow

Title

Manager

Phone

(313) 212-6733

Specialties & licenses 1

Addresses

Other identifiers 5

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.

• Antoinette Toy Richbow

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1336492701
  NPD (past)

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369958400000",
    "number": "1972940831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9781 DOTTIE JEWEL AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891476766",
            "telephone_number": "313-212-6733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9781 DOTTIE JEWEL AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891476766",
            "telephone_number": "313-212-6733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW VANATGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-05-31",
        "status": "A",
        "authorized_official_last_name": "RICHBOW",
        "authorized_official_first_name": "NATHANIAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "313-212-6733"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295098788",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699872614",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124383880",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336492701",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669735247",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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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 May 31, 2013; 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.