MEDICARE: PRESS ON LLC

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	:	1497397301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESS ON LLC

Provider Business Mailing Address
First Line	:	5631 MAMMOTH MOUNTAIN ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-2419
Country	:	US
Telephone Number	:	702-504-3767
Fax Number	:

Provider Business Practice Location Address
First Line	:	5712 SAINT ELIAS ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-2427
Country	:	US
Telephone Number	:	170-250-4376
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEMONTE ROUNDTREE
Credential	:
Telephone Number	:	702-936-9045

Provider Enumeration Date	:	10/11/2019
Last Update Date	:	08/27/2020

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Directions to “PRESS ON LLC ” Practice Location

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