Provider Demographics
NPI:1740981752
Name:PASSION BEHAVIORAL CENTER AND FAMILY SERVICES , LLC
Entity type:Organization
Organization Name:PASSION BEHAVIORAL CENTER AND FAMILY SERVICES , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-349-6919
Mailing Address - Street 1:1516 E TROPICANA AVE STE 175
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-8322
Mailing Address - Country:US
Mailing Address - Phone:702-955-0413
Mailing Address - Fax:
Practice Address - Street 1:1516 E TROPICANA AVE STE 175
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-8322
Practice Address - Country:US
Practice Address - Phone:702-955-0413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty