Provider Demographics
NPI:1093255762
Name:HIGHER LEVEL BHS
Entity type:Organization
Organization Name:HIGHER LEVEL BHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NYANDA
Authorized Official - Middle Name:KERRIAN
Authorized Official - Last Name:DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-561-5015
Mailing Address - Street 1:1434 NEYLAND DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4849
Mailing Address - Country:US
Mailing Address - Phone:702-561-5015
Mailing Address - Fax:
Practice Address - Street 1:1434 NEYLAND DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-4849
Practice Address - Country:US
Practice Address - Phone:702-561-5015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGHER LEVEL BHS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20171130611251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health