Provider Demographics
NPI:1699583450
Name:LAS VEGAS CHIPS
Entity type:Organization
Organization Name:LAS VEGAS CHIPS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-560-6584
Mailing Address - Street 1:201 LAS VEGAS BLVD S
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-5780
Mailing Address - Country:US
Mailing Address - Phone:702-560-6584
Mailing Address - Fax:
Practice Address - Street 1:3690 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3300
Practice Address - Country:US
Practice Address - Phone:702-560-6584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-26
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility