Provider Demographics
NPI:1962284638
Name:ANU BEHAVIORAL HEALTH CENTER LLC
Entity type:Organization
Organization Name:ANU BEHAVIORAL HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WYSOR
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:702-578-5982
Mailing Address - Street 1:1848 GENTLE DAWN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-2058
Mailing Address - Country:US
Mailing Address - Phone:702-578-5982
Mailing Address - Fax:
Practice Address - Street 1:601 E CHARLESTON BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-1508
Practice Address - Country:US
Practice Address - Phone:702-578-5982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)