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NPI Code Detail

MEDICARE: SEEDS2SUCCEED

MEDICARE: SEEDS2SUCCEED
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
1251S00000XCommunity/Behavioral Health Agency5419-CNV
2251S00000XCommunity/Behavioral Health Agency6407-CNV

General Provider Information

NPI Number : 1255668422
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEEDS2SUCCEED
Provider Business Mailing Address
First Line : 3087 E WARM SPRINGS RD
Second Line : #400
City : LAS VEGAS
State : NV
Zip : 89120-3753
Country : US
Telephone Number : 702-985-3216
Fax Number : 702-684-7046
Provider Business Practice Location Address
First Line : 3087 E WARM SPRINGS RD
Second Line : #400
City : LAS VEGAS
State : NV
Zip : 89120-3753
Country : US
Telephone Number : 702-985-3216
Fax Number : 702-684-7046
Authorized Official
Title or Position : DIRECTOR
Name : NOEL REID
Credential : LCSW
Telephone Number : 702-985-3216
Provider Enumeration Date : 11/09/2009
Last Update Date : 06/29/2016

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Directions to “SEEDS2SUCCEED ” Practice Location

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