MEDICARE: WORD INTO ACTION

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	:	1316421407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WORD INTO ACTION

Provider Business Mailing Address
First Line	:	1701 H ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-2533
Country	:	US
Telephone Number	:	702-345-1099
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 H ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-2533
Country	:	US
Telephone Number	:	702-345-1099
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JEDEDIAH FRIESEN
Credential	:
Telephone Number	:	702-345-1099

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	09/24/2018

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Directions to “WORD INTO ACTION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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