Provider Demographics
NPI:1689267676
Name:NOVUM BEHAVIORAL HEALTH SYSTEMS, LLC
Entity Type:Organization
Organization Name:NOVUM BEHAVIORAL HEALTH SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:MALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-978-8000
Mailing Address - Street 1:2921 N TENAYA WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1409
Mailing Address - Country:US
Mailing Address - Phone:702-978-8000
Mailing Address - Fax:702-978-8001
Practice Address - Street 1:2600 N 44TH ST STE 108
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-1555
Practice Address - Country:US
Practice Address - Phone:702-978-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty