Provider Demographics
NPI:1275917510
Name:CSSI BEHAVIORAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:CSSI BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-639-4400
Mailing Address - Street 1:3013 N RANCHO DR
Mailing Address - Street 2:SUITE 127
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3345
Mailing Address - Country:US
Mailing Address - Phone:702-639-4400
Mailing Address - Fax:
Practice Address - Street 1:3013 N RANCHO DR
Practice Address - Street 2:SUITE 127
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3345
Practice Address - Country:US
Practice Address - Phone:702-639-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty