Provider Demographics
NPI:1639899636
Name:MORIAH BEHAVIORAL HEALTH CO.
Entity Type:Organization
Organization Name:MORIAH BEHAVIORAL HEALTH CO.
Other - Org Name:EDNA AVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, BILLING & COLLECTIONS
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-203-9222
Mailing Address - Street 1:8635 W SAHARA AVE # 10
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5858
Mailing Address - Country:US
Mailing Address - Phone:725-272-0330
Mailing Address - Fax:
Practice Address - Street 1:7390 EDNA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2902
Practice Address - Country:US
Practice Address - Phone:725-272-0330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility