Provider Demographics
NPI:1255842423
Name:GOOD SAMARITAN BEHAVIORAL HEALTH AND COMMUNITY SERVICES
Entity Type:Organization
Organization Name:GOOD SAMARITAN BEHAVIORAL HEALTH AND COMMUNITY SERVICES
Other - Org Name:GOOD SAMARITAN CRISIS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-332-1856
Mailing Address - Street 1:3365 WYNN RD STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8202
Mailing Address - Country:US
Mailing Address - Phone:702-331-3845
Mailing Address - Fax:
Practice Address - Street 1:3365 WYNN RD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8202
Practice Address - Country:US
Practice Address - Phone:702-331-3845
Practice Address - Fax:702-331-3886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health