Provider Demographics
NPI:1538499801
Name:VALLEY VIEW COMMUNITY CARES BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:VALLEY VIEW COMMUNITY CARES BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:YLONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-480-6421
Mailing Address - Street 1:2037 ENGLESTAD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-4026
Mailing Address - Country:US
Mailing Address - Phone:702-480-6421
Mailing Address - Fax:
Practice Address - Street 1:2037 ENGLESTAD ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-4026
Practice Address - Country:US
Practice Address - Phone:702-480-6421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization