Provider Demographics
NPI:1144561101
Name:PEOPLES BEHAVIOR CARE
Entity Type:Organization
Organization Name:PEOPLES BEHAVIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIROL SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RICKEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEOPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-834-0868
Mailing Address - Street 1:1121 W ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-2946
Mailing Address - Country:US
Mailing Address - Phone:702-834-0868
Mailing Address - Fax:
Practice Address - Street 1:1121 W ADAMS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-2946
Practice Address - Country:US
Practice Address - Phone:702-834-0868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV=========Medicaid