Provider Demographics
NPI:1881089175
Name:ARBOR BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:ARBOR BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KENDRID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-212-1347
Mailing Address - Street 1:2575 MONTESSOURI ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3060
Mailing Address - Country:US
Mailing Address - Phone:725-212-1347
Mailing Address - Fax:725-212-1347
Practice Address - Street 1:2575 MONTESSOURI ST STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3060
Practice Address - Country:US
Practice Address - Phone:725-212-1347
Practice Address - Fax:725-212-1347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-02
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6840-C1041C0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV201511354156Medicaid