RAY TRAVIS GOODIN NPI 1023566023

NPI Information

  • NPI: 1023566023
  • Provider Name: RAY TRAVIS GOODIN
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Individual
  • Address: 2625 WYANDOTTE ST
    # 17
    LAS VEGAS, NV
    ZIP 89102
  • Phone: (313) 433-7330

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NPI Details

Ray Travis Goodin is a community based residential treatment facility, intellectual and/or developmental disabilities in Las Vegas, NV. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. Ray Travis Goodin NPI is 1023566023. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2625 WYANDOTTE ST
# 17
LAS VEGAS, NV
ZIP 89102-471
Phone: (313) 433-7330

The enumeration date for this NPI number is 9/19/2016 and was last updated on 10/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1106S00000XBehavior TechnicianNo
2320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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