MEDICARE: PALO VERDE CHILD AND FAMILY SERVICES, 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	170300000X	Genetic Counselor (M.S.)		NV

General Provider Information

NPI Number	:	1568684264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALO VERDE CHILD AND FAMILY SERVICES, INC

Provider Business Mailing Address
First Line	:	2801 S VALLEY VIEW BLVD STE 14
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-0116
Country	:	US
Telephone Number	:	702-243-4357
Fax Number	:	702-228-0735

Provider Business Practice Location Address
First Line	:	2801 S VALLEY VIEW BLVD STE 14
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-0116
Country	:	US
Telephone Number	:	702-243-4357
Fax Number	:	702-228-0735

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MARK GETTMAN
Credential	:
Telephone Number	:	702-243-4357

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/22/2020

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