Provider Demographics
NPI:1063945855
Name:BEAUTIFUL HEARTS BHC
Entity type:Organization
Organization Name:BEAUTIFUL HEARTS BHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANAY
Authorized Official - Middle Name:JAZMINE
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-396-1768
Mailing Address - Street 1:3281 N DECATUR BLVD STE 180
Mailing Address - Street 2:180
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3269
Mailing Address - Country:US
Mailing Address - Phone:702-396-1768
Mailing Address - Fax:
Practice Address - Street 1:3281 N DECATUR BLVD STE 180
Practice Address - Street 2:180
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3269
Practice Address - Country:US
Practice Address - Phone:702-396-1768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVC20170125-0988000000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health