Provider Demographics
NPI:1598202244
Name:INFINITE POSSIBILITIES BEHAVIORAL HEALTHCARE LLC
Entity Type:Organization
Organization Name:INFINITE POSSIBILITIES BEHAVIORAL HEALTHCARE LLC
Other - Org Name:INFINITE POSSIBILITIES BEHAVIORAL HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBERS
Authorized Official - Prefix:
Authorized Official - First Name:KAIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-376-0177
Mailing Address - Street 1:650 S TOWN CENTER DR
Mailing Address - Street 2:#2079
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-4419
Mailing Address - Country:US
Mailing Address - Phone:702-426-9478
Mailing Address - Fax:
Practice Address - Street 1:650 S TOWN CENTER DR
Practice Address - Street 2:#2079
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-4419
Practice Address - Country:US
Practice Address - Phone:702-426-9478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health