MEDICARE: TAKING CHARGE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1114341179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAKING CHARGE LLC

Provider Business Mailing Address
First Line	:	2350 SOUTH JONES
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3502
Country	:	US
Telephone Number	:	702-900-7372
Fax Number	:

Provider Business Practice Location Address
First Line	:	2350 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3103
Country	:	US
Telephone Number	:	702-900-7372
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	BELINDA MASON
Credential	:
Telephone Number	:	702-900-7372

Provider Enumeration Date	:	02/12/2014
Last Update Date	:	02/26/2014

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Directions to “TAKING CHARGE LLC ” Practice Location

Language	Start Address	Practice Location

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