Provider Demographics
NPI:1841870334
Name:VEGAS VALLEY BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:VEGAS VALLEY BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLASENOR-
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-767-8487
Mailing Address - Street 1:3085 S JONES BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-6767
Mailing Address - Country:US
Mailing Address - Phone:702-767-8487
Mailing Address - Fax:
Practice Address - Street 1:3085 S JONES BLVD STE E
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6767
Practice Address - Country:US
Practice Address - Phone:702-767-8487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health