Provider Demographics
NPI:1295399111
Name:GYHE, LLC
Entity Type:Organization
Organization Name:GYHE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:RENADE
Authorized Official - Last Name:WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:CPC-INTERN
Authorized Official - Phone:702-818-0247
Mailing Address - Street 1:777 E QUARTZ AVE # 7012
Mailing Address - Street 2:
Mailing Address - City:JEAN
Mailing Address - State:NV
Mailing Address - Zip Code:89019-8501
Mailing Address - Country:US
Mailing Address - Phone:702-723-5388
Mailing Address - Fax:702-723-5389
Practice Address - Street 1:777 EAST QUARTZ AVENUE
Practice Address - Street 2:SUITE B & E
Practice Address - City:JEAN
Practice Address - State:NV
Practice Address - Zip Code:89019-8501
Practice Address - Country:US
Practice Address - Phone:702-723-5388
Practice Address - Fax:702-723-5389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1073891859Medicaid