MEDICARE: JUST LIKE FAMILY

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	305R00000X	Preferred Provider Organization	NV20141299285	NV

General Provider Information

NPI Number	:	1659766137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUST LIKE FAMILY

Provider Business Mailing Address
First Line	:	1118 KRUGER CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-9005
Country	:	US
Telephone Number	:	702-489-4503
Fax Number	:

Provider Business Practice Location Address
First Line	:	1118 KRUGER CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-9005
Country	:	US
Telephone Number	:	702-489-4503
Fax Number	:

Authorized Official
Title or Position	:	MANAGER AGENT
Name	:	ALFORTRA DIANE TURNER
Credential	:
Telephone Number	:	702-489-4503

Provider Enumeration Date	:	04/01/2015
Last Update Date	:	04/01/2015

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Directions to “JUST LIKE FAMILY ” Practice Location

Language	Start Address	Practice Location

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