Provider Demographics
NPI:1881200723
Name:BAUZA NEUROPSYCHIATRY CENTER LLC
Entity Type:Organization
Organization Name:BAUZA NEUROPSYCHIATRY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:RODRIGUEZ BAUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-810-0066
Mailing Address - Street 1:4268 ROANRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2113
Mailing Address - Country:US
Mailing Address - Phone:702-810-0066
Mailing Address - Fax:
Practice Address - Street 1:4268 ROANRIDGE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2113
Practice Address - Country:US
Practice Address - Phone:702-810-0066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Single Specialty
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty