Provider Demographics
NPI:1285029033
Name:DIVERSIFIED COMMUNITY SERVICES, CDC
Entity Type:Organization
Organization Name:DIVERSIFIED COMMUNITY SERVICES, CDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, MSW
Authorized Official - Phone:702-749-8500
Mailing Address - Street 1:2820 E LAKE MEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-6514
Mailing Address - Country:US
Mailing Address - Phone:702-749-8500
Mailing Address - Fax:702-749-8509
Practice Address - Street 1:2820 E LAKE MEAD BLVD
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6514
Practice Address - Country:US
Practice Address - Phone:702-749-8500
Practice Address - Fax:702-749-8509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty