MEDICARE: UNITY FAMILY SERVICES

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		NV

General Provider Information

NPI Number	:	1356644686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITY FAMILY SERVICES

Provider Business Mailing Address
First Line	:	2455 W CHEYENNE AVE
Second Line	:	140
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-4325
Country	:	US
Telephone Number	:	702-646-7570
Fax Number	:

Provider Business Practice Location Address
First Line	:	2455 W CHEYENNE AVE
Second Line	:	140
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-4325
Country	:	US
Telephone Number	:	702-646-7570
Fax Number	:

Authorized Official
Title or Position	:	HUMAN RESOURCES SPECIALIST
Name	:	CHARLOTTE JENKINS
Credential	:
Telephone Number	:	702-633-7570

Provider Enumeration Date	:	12/08/2010
Last Update Date	:	12/08/2010

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