MEDICARE: JRT DEVELOPMENT 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1376888487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JRT DEVELOPMENT SERVICES

Provider Business Mailing Address
First Line	:	6365 SIMMONS AVE 145-131
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89031
Country	:	US
Telephone Number	:	702-823-0056
Fax Number	:	702-586-3395

Provider Business Practice Location Address
First Line	:	1403 SILENT SUNSET AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89084
Country	:	US
Telephone Number	:	702-810-2422
Fax Number	:	702-586-3955

Authorized Official
Title or Position	:	CEO
Name	:	MS. JULIA ROMI THOMAS
Credential	:	LPT
Telephone Number	:	702-823-0056

Provider Enumeration Date	:	11/29/2012
Last Update Date	:	11/29/2012

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