Provider Demographics
NPI:1285958900
Name:BILINGUAL BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:BILINGUAL BEHAVIORAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGY RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JANET
Authorized Official - Last Name:ROEHRIG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-451-7542
Mailing Address - Street 1:4660 S EASTERN AVE
Mailing Address - Street 2:STE 104A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6137
Mailing Address - Country:US
Mailing Address - Phone:702-451-7542
Mailing Address - Fax:702-450-4239
Practice Address - Street 1:4660 S EASTERN AVE
Practice Address - Street 2:STE 104A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6137
Practice Address - Country:US
Practice Address - Phone:702-451-7542
Practice Address - Fax:702-450-4239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPYO334261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health