Provider Demographics
NPI:1073256046
Name:EHS NEVADA, LLC
Entity Type:Organization
Organization Name:EHS NEVADA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BREATHITT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-799-2247
Mailing Address - Street 1:123 W NYE LN STE 116
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0899
Mailing Address - Country:US
Mailing Address - Phone:602-799-2247
Mailing Address - Fax:
Practice Address - Street 1:123 W NYE LN STE 116
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-0899
Practice Address - Country:US
Practice Address - Phone:602-799-2247
Practice Address - Fax:602-218-7506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty