Provider Demographics
NPI:1346764081
Name:GENTLE TOUCH BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:GENTLE TOUCH BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEYANA
Authorized Official - Middle Name:LANICE JAMILL
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-253-5907
Mailing Address - Street 1:3365 W CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-5112
Mailing Address - Country:US
Mailing Address - Phone:510-253-5907
Mailing Address - Fax:
Practice Address - Street 1:3365 W CRAIG RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-5112
Practice Address - Country:US
Practice Address - Phone:510-253-5907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20171381956251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health