MEDICARE: SAHARA BEHAVIORAL HEALTH SERVICES 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	:	1295224145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAHARA BEHAVIORAL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	6551 MCCARRAN ST APT 3043
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-1447
Country	:	US
Telephone Number	:	702-417-1464
Fax Number	:

Provider Business Practice Location Address
First Line	:	6551 MCCARRAN ST APT 3043
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-1447
Country	:	US
Telephone Number	:	702-417-1464
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DARNISHA THOMAS
Credential	:
Telephone Number	:	702-417-1464

Provider Enumeration Date	:	05/07/2018
Last Update Date	:	05/07/2018

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