MEDICARE: BAILEIGHS FAMILY SERVICES 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	:	1649519786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAILEIGHS FAMILY SERVICES LLC.

Provider Business Mailing Address
First Line	:	6509 CHATTERER ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-2254
Country	:	US
Telephone Number	:	702-277-6236
Fax Number	:

Provider Business Practice Location Address
First Line	:	6509 CHATTERER ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-2254
Country	:	US
Telephone Number	:	702-277-6236
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CAREY RODGERS JR.
Credential	:
Telephone Number	:	702-277-6236

Provider Enumeration Date	:	02/09/2013
Last Update Date	:	02/09/2013

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Directions to “BAILEIGHS FAMILY SERVICES LLC. ” Practice Location

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