MEDICARE: SOUTHERN NEVADA CHILDREN FIRST

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	251C00000X	Developmentally Disabled Services Day Training Agency
2	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144451949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN NEVADA CHILDREN FIRST

Provider Business Mailing Address
First Line	:	9811 W CHARLESTON BLVD # 2-863
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7528
Country	:	US
Telephone Number	:	702-719-9773
Fax Number	:	702-897-2984

Provider Business Practice Location Address
First Line	:	2637 CHIN CACTUS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-1449
Country	:	US
Telephone Number	:	702-719-9773
Fax Number	:	702-989-7198

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MONIQUE HARRIS
Credential	:	MSW, LSW
Telephone Number	:	702-719-9773

Provider Enumeration Date	:	07/29/2009
Last Update Date	:	07/29/2009

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Directions to “SOUTHERN NEVADA CHILDREN FIRST ” Practice Location

Language	Start Address	Practice Location

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