Organization
SBH - MONTEVISTA LLC
Active
Other names
Montevist Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES CAGLE (CFO)
(901) 969-3114
Entity
Organization
Contact information
Practice address
5900 W ROCHELLE AVE, LAS VEGAS, NV 89103-3304
(702) 364-1111
(702) 251-1212
Mailing address
5900 W ROCHELLE AVE, LAS VEGAS, NV 89103-3304
(702) 364-1111
(702) 251-1212
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
283Q00000X
Psychiatric Hospital
Primary
—
—
283X00000X
Rehabilitation Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001302890
—
NV
05
—
100508929
—
NV
05
—
100508930
—
NV
01
—
880299907001
CHAMPUS
NV
01
—
NV2965
BLUE CROSS
NV
Enumeration date
08/05/2006
Last updated
05/20/2021
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