Provider Demographics
NPI:1962595348
Name:SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF NEVADA, INC.
Entity type:Organization
Organization Name:SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF NEVADA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:EARL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:702-385-5331
Mailing Address - Street 1:10100 ELIDA RD
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-9056
Mailing Address - Country:US
Mailing Address - Phone:419-695-8010
Mailing Address - Fax:419-695-0004
Practice Address - Street 1:4285 N RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3446
Practice Address - Country:US
Practice Address - Phone:702-385-5331
Practice Address - Fax:702-894-5678
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-30
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV006102507Medicaid
NV100507947Medicaid
NV100507948Medicaid
NV100507953Medicaid
NV100509297Medicaid
NV9005042930Medicaid
NV9005042922Medicaid
NV9005042906Medicaid
NV100507950Medicaid
NV100507951Medicaid
NV100509901Medicaid
NV100507952Medicaid
NV9005042914Medicaid