WHEATLEY DE FORGE LLC NPI 1487205761

Clinic/Center (Mental Health (Including Community Mental Health Center)) in Las Vegas, NV

Organization Clinic/Center Mental Health (Including Community Menta...

About WHEATLEY DE FORGE LLC

Wheatley De Forge Llc is a provider established in Las Vegas, Nevada specializing in clinic/center. The NPI number of Wheatley De Forge Llc is 1487205761 and was assigned on September 2019. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated September 2019. The authorized official of this NPI record is Mr. Warren John Wheatley Msw (Owner / Clinical Director)

NPI

1487205761

Provider NameWHEATLEY DE FORGE LLC
Provider Location Address4550 W OAKEY BLVD STE 101 LAS VEGAS, NV 89102
Provider Mailing Address2620 REGATTA DR STE 102 LAS VEGAS, NV 89128
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-26-2019
Last Update Date09-26-2019

Primary Taxonomy

Taxonomy Code261QM0801X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationMental Health (Including Community Mental Health Center)

Business Address

WHEATLEY DE FORGE LLC
4550 W OAKEY BLVD STE 101
LAS VEGAS, NV
ZIP 89102
Phone: (702) 778-9875
Fax: (702) 778-9863

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Mailing Address

WHEATLEY DE FORGE LLC
2620 REGATTA DR STE 102
LAS VEGAS, NV
ZIP 89128
Phone: (702) 778-9875
Fax: (702) 778-9875

Authorized Official

Authorized Official NameMR. WARREN JOHN WHEATLEY MSW
Authorized Official TitleOWNER / CLINICAL DIRECTOR
Authorized Official Phone(702) 250-2520

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1043708878 ARMOND SHIAN
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1053809251 MICHIKO NOE
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1164910105 DON KIM
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1215423868 DAMILIA CRUZ
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1215424015 KATERYN HIDALGO
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1235627290 SATENIK MELKONYAN
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1285122911 EUSTAQUIA D RODRIGUEZ-AGUABELLA
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1467949198 ESTRELLA RODRIGUEZ
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1477041200 MARICELA SOLIS
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1497243224 GLORIA TERRAZAS
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1538657598 EDGAR AMALYAN
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1578051306 TAMARA SERVENTI
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1588152300 MABEL PEREZ
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1588152318 AMBER ROBERTS
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1730677568 TAMMY WATTS
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1780181933 ENIER AGRAMONTE - TELLEZ
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1902394943 LEA HARNEY
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1912495110 KAYLA LOGAN
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1912495870 YADELMY LEIVA
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999
1922595735 NAAOLU LATUKEFU
Individual
Technician (Personal Care Attendant)4550 W OAKEY BLVD STE 101
LAS VEGAS, NV 89102
(702) 906-1999

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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