MEDICARE: HEART OF DAVID BHS

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	:	1396248324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART OF DAVID BHS

Provider Business Mailing Address
First Line	:	3540 W SAHARA AVE # 119
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5816
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3318 N DECATUR BLVD UNIT 2168
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3241
Country	:	US
Telephone Number	:	951-452-7763
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HENRY PEREZ
Credential	:
Telephone Number	:	951-452-7763

Provider Enumeration Date	:	03/15/2018
Last Update Date	:	03/15/2018

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Directions to “HEART OF DAVID BHS ” Practice Location

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