MEDICARE: FRESH AIR AND SUNSHINE 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

General Provider Information

NPI Number	:	1497028187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRESH AIR AND SUNSHINE FAMILY SERVICES

Provider Business Mailing Address
First Line	:	7465 W LAKE MEAD BLVD
Second Line	:	STE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1032
Country	:	US
Telephone Number	:	702-981-0614
Fax Number	:

Provider Business Practice Location Address
First Line	:	7465 W LAKE MEAD BLVD
Second Line	:	STE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1032
Country	:	US
Telephone Number	:	702-981-0614
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ERICA BELL
Credential	:
Telephone Number	:	702-981-0614

Provider Enumeration Date	:	02/11/2012
Last Update Date	:	02/11/2012

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