Provider Demographics
NPI:1053806745
Name:HUMBLE STEPS BHS
Entity type:Organization
Organization Name:HUMBLE STEPS BHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BELOTE-BINFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-764-8440
Mailing Address - Street 1:7345 S DURANGO DR # B107-137
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3653
Mailing Address - Country:US
Mailing Address - Phone:702-764-8440
Mailing Address - Fax:
Practice Address - Street 1:3450 W CHEYENNE AVE STE 500
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8225
Practice Address - Country:US
Practice Address - Phone:702-269-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20181357901251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health