MEDICARE: AVERY PAPESH

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	:	1710261292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVERY PAPESH

Provider Business Mailing Address
First Line	:	3431 E SUNSET RD BLDG C
Second Line	:	STE 303-23
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3252
Country	:	US
Telephone Number	:	702-686-8807
Fax Number	:	702-413-6364

Provider Business Practice Location Address
First Line	:	3431 E SUNSET RD BLDG C
Second Line	:	STE 303-23
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3252
Country	:	US
Telephone Number	:	702-686-8807
Fax Number	:	702-413-6364

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

Provider Enumeration Date	:	10/03/2011
Last Update Date	:	10/03/2011

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Directions to “ AVERY PAPESH ” Practice Location

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