Provider Demographics
NPI:1518393032
Name:ASSERTIVE HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:ASSERTIVE HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:C
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:702-302-1105
Mailing Address - Street 1:3315 E RUSSELL RD
Mailing Address - Street 2:STE A4 #119
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3459
Mailing Address - Country:US
Mailing Address - Phone:702-302-1105
Mailing Address - Fax:702-202-6551
Practice Address - Street 1:2451 N RAINBOW BLVD
Practice Address - Street 2:APT# 2078
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-4502
Practice Address - Country:US
Practice Address - Phone:702-302-1105
Practice Address - Fax:702-202-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVP50-03194-3-166019320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness