Provider Demographics
NPI:1104161207
Name:NEW VISIONS BEHAVIORAL HEALTH ACADEMY LLC
Entity type:Organization
Organization Name:NEW VISIONS BEHAVIORAL HEALTH ACADEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:LORENZO
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-506-3921
Mailing Address - Street 1:3550 W. CHEYENNE AVE.
Mailing Address - Street 2:STE. 110
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-8252
Mailing Address - Country:US
Mailing Address - Phone:702-570-5421
Mailing Address - Fax:702-570-5062
Practice Address - Street 1:3550 W. CHEYENNE AVE.
Practice Address - Street 2:STE. 110
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8252
Practice Address - Country:US
Practice Address - Phone:702-570-5421
Practice Address - Fax:702-570-5062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health