Provider Demographics
NPI:1104359488
Name:JECHEBEDS BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:JECHEBEDS BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:702-589-1057
Mailing Address - Street 1:420 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3015
Mailing Address - Country:US
Mailing Address - Phone:702-589-1057
Mailing Address - Fax:725-201-2959
Practice Address - Street 1:420 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3015
Practice Address - Country:US
Practice Address - Phone:702-589-1057
Practice Address - Fax:725-201-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health