MEDICARE: ISU INC

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	:	1528452224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISU INC

Provider Business Mailing Address
First Line	:	1745 N. NELLIS BLVD #A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-3673
Country	:	US
Telephone Number	:	702-459-7500
Fax Number	:	702-459-1176

Provider Business Practice Location Address
First Line	:	1745 N. NELLIS BLVD
Second Line	:	STE A
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-3673
Country	:	US
Telephone Number	:	702-459-7500
Fax Number	:	702-459-1176

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHUKA E. HUMPHREYS
Credential	:	PH.D
Telephone Number	:	702-459-7500

Provider Enumeration Date	:	03/20/2015
Last Update Date	:	03/20/2015

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Directions to “ISU INC ” Practice Location

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