Provider Demographics
NPI:1053832543
Name:A NEW WAY BEHAVIORAL SERVICES LLC
Entity Type:Organization
Organization Name:A NEW WAY BEHAVIORAL SERVICES LLC
Other - Org Name:A NEW WAY BEHAVIORAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ISAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-986-4090
Mailing Address - Street 1:5154 S JONES BLVD
Mailing Address - Street 2:204
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118
Mailing Address - Country:US
Mailing Address - Phone:702-986-4090
Mailing Address - Fax:
Practice Address - Street 1:5154 S JONES BLVD UNIT 204
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-0529
Practice Address - Country:US
Practice Address - Phone:702-986-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness