Provider Demographics
| NPI: | 1841778990 |
|---|---|
| Name: | TAKING A.C.T.I.O.N. ( A COMMITMENT TO IMPACT OUR NEIGHBORHOODS) LLC |
| Entity Type: | Organization |
| Organization Name: | TAKING A.C.T.I.O.N. ( A COMMITMENT TO IMPACT OUR NEIGHBORHOODS) LLC |
| Other - Org Name: | TAKING A.C.T.I.O.N. LLC |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER (CEO) |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | BREAUNA |
| Authorized Official - Middle Name: | C |
| Authorized Official - Last Name: | NIEVES |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 702-591-1231 |
| Mailing Address - Street 1: | 4780 W ANN RD |
| Mailing Address - Street 2: | STE 5-282 |
| Mailing Address - City: | NORTH LAS VEGAS |
| Mailing Address - State: | NV |
| Mailing Address - Zip Code: | 89031-3470 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 702-818-9305 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 4780 W ANN RD |
| Practice Address - Street 2: | STE 5-282 |
| Practice Address - City: | NORTH LAS VEGAS |
| Practice Address - State: | NV |
| Practice Address - Zip Code: | 89031-3470 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 702-818-9305 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | TAKING A.C.T.I.O.N. LLC |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2018-07-31 |
| Last Update Date: | 2023-07-20 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 102X00000X | Behavioral Health & Social Service Providers | Poetry Therapist | Group - Multi-Specialty | |
| No | 171W00000X | Other Service Providers | Contractor | Group - Multi-Specialty | |
| No | 251B00000X | Agencies | Case Management | ||
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | ||
| No | 251S00000X | Agencies | Community/Behavioral Health | ||
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | |
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
| No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | ||
| No | 385H00000X | Respite Care Facility | Respite Care | ||
| No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child | |
| No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |
