Provider Demographics
NPI:1336767144
Name:A REGAL BEHAVIORAL AGENCY LLC
Entity Type:Organization
Organization Name:A REGAL BEHAVIORAL AGENCY LLC
Other - Org Name:A REGAL BEHAVIORAL AGENCY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:INGUANZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-661-4242
Mailing Address - Street 1:9640 W TROPICANA AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-2604
Mailing Address - Country:US
Mailing Address - Phone:702-661-4242
Mailing Address - Fax:
Practice Address - Street 1:9640 W TROPICANA AVE STE 116
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-2604
Practice Address - Country:US
Practice Address - Phone:702-661-4242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health