OrganizationActive
Ignite Teen Treatment, LLC
NPI 1063984219 · Psychiatric Residential Treatment Facility · Las Vegas, NV
Provider details
- NPI number
- 1063984219
- Entity type
- Organization
- Primary specialty
- Psychiatric Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Alan Bond, Cfo(570) 203-9222
Specialties & taxonomies
Residential Treatment Facilities
Ambulatory Health Care Facilities
- Substance Abuse Rehabilitation Facility324500000X
Residential Treatment Facilities
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3621 Bahama Bay Ct
Las Vegas, NV 89147-6800
Phone: (310) 721-6447
Street-level locationGet directions
Mailing address
512 Northampton St # 158
Edwardsville, PA 18704-4560
Other names (DBA / former)
- Doing business as
- Ignite Teen Treatment
- Doing business as
- Ignite Teen Treatment
Registry dates
- Enumerated
- 2018-12-28
- Last updated
- 2023-11-20
- Certified
- 2023-11-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.