Provider Demographics
NPI:1922806132
Name:LUXE BEHAVIORAL HEALTH SOLUTIONS LLC
Entity type:Organization
Organization Name:LUXE BEHAVIORAL HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SENORIA
Authorized Official - Middle Name:SHANTE
Authorized Official - Last Name:WALLICAN-NESBIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-493-7889
Mailing Address - Street 1:1542 FLAMMANG DR STE 1040
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-4370
Mailing Address - Country:US
Mailing Address - Phone:319-493-7889
Mailing Address - Fax:
Practice Address - Street 1:158 SAINT CROIX DR
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703
Practice Address - Country:US
Practice Address - Phone:319-493-7889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness