MEDICARE: FIRST INITIATIVE

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	:	1336482272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST INITIATIVE

Provider Business Mailing Address
First Line	:	370 CASA NORTE DR UNIT 2030
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-3328
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	370 CASA NORTE DR UNIT 2030
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-3328
Country	:	US
Telephone Number	:	702-420-3761
Fax Number	:

Authorized Official
Title or Position	:	EX DIRECTOR
Name	:	SHAMEIKA ADAMS
Credential	:
Telephone Number	:	702-428-7338

Provider Enumeration Date	:	03/28/2013
Last Update Date	:	03/28/2013

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Directions to “FIRST INITIATIVE ” Practice Location

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