MEDICARE: TRUE POSSIBILITIES 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1508349119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUE POSSIBILITIES LLC

Provider Business Mailing Address
First Line	:	PO BOX 3305
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89041-3305
Country	:	US
Telephone Number	:	775-209-9213
Fax Number	:

Provider Business Practice Location Address
First Line	:	7232 DAINTREE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3303
Country	:	US
Telephone Number	:	702-279-9157
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MEGAN POTE
Credential	:
Telephone Number	:	775-209-9213

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	12/10/2018

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