MEDICARE: YUDAIMY MESA GRANADOS

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	106S00000X	Behavior Technician	RBT3929	NV

General Provider Information

NPI Number	:	1629858253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUDAIMY MESA GRANADOS

Provider Business Mailing Address
First Line	:	10585 MEDICINE BOW ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-4906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10585 MEDICINE BOW ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-4906
Country	:	US
Telephone Number	:	702-665-1519
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2023
Last Update Date	:	08/20/2024

Similar Medicare Providers

1669710125 — LALEH BEIJAN BCBA, LBA
Practice Location Address:

10585 MEDICINE BOW ST
LAS VEGAS, NV
89183-4906

Practice Phone: 757-672-4174
Practice Fax:

1447680806 — VALERIE KAYE ANTHONY
Practice Location Address:

10598 MEDICINE BOW ST
LAS VEGAS, NV
89183-4906

Practice Phone: 209-499-5201
Practice Fax:

1366167207 — MOVING FORWARD BEHAVIORAL HEALTH LLC
Practice Location Address:

10585 MEDICINE BOW ST
LAS VEGAS, NV
89183-4906

Practice Phone: 757-672-4174
Practice Fax:

1063375947 — BYRON ROWE
Practice Location Address:

3265 W LAKE MEAD BLVD UNIT 1117 , 1117
NORTH LAS VEGAS, NV
89032-4906

Practice Phone: 725-264-1104
Practice Fax:

1083821813 — UNILIFE MEDICAL SUPPLY, LLC
Practice Location Address:

3950 E SUNSET RD STE 116
LAS VEGAS, NV
89120-4906

Practice Phone: 702-897-7070
Practice Fax: 702-647-1142

1366001950 — GERARDO A MARIANO
Practice Location Address:

4462 FARMCREST DR
LAS VEGAS, NV
89121-4906

Practice Phone: 702-433-2879
Practice Fax:

Directions to “ YUDAIMY MESA GRANADOS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.