Genesis Vida Health Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GENESIS VIDA HEALTH SERVICES

Practice address

6075 Silken Saddle St
North Las Vegas, NV 89031-6854

Phone

(702) 472-6231

NPI assigned

Apr 11, 2018

Organization subpart

No

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

Authorized official

Name

Kenyatta Fletcher

Title

Owner

Phone

(702) 472-6231

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1982101358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 EL PARQUE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891023502",
            "telephone_number": "702-472-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6075 SILKEN SADDLE ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890316854",
            "telephone_number": "702-472-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS VIDA HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-11",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "KENYATTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-472-6231"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zion Gayle
• GBPP LLC
• Mary J Geer, LCSW
• Genesis
• Genesis Treatment Foster Care Agency
• Thomas Gennaro II
• Gentle Minds of Nevada LLC
• Gentle Touch Behavioral Health LLC
• Eric Gentle, DO, MHS
• George Tan MD PLLC (Vegas Digestive Health Center)

• Community/Behavioral Health Agency in North Las Vegas, NV
• Providers in North 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 Oct 9, 2020; 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.