MEDICARE: FAMILY SUPPORT SERVICES OF NEVADA 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	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1154147981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY SUPPORT SERVICES OF NEVADA LLC

Provider Business Mailing Address
First Line	:	400 S 4TH ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-6201
Country	:	US
Telephone Number	:	833-888-2166
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 S 4TH ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-6201
Country	:	US
Telephone Number	:	833-888-2166
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOSEPH NGARUIYA
Credential	:
Telephone Number	:	833-888-2166

Provider Enumeration Date	:	11/26/2024
Last Update Date	:	12/04/2024

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