MEDICARE: COMMUNITIES IN SCHOOLS OF NEVAD

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	124Q00000X	Dental Hygienist

General Provider Information

NPI Number	:	1790017382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITIES IN SCHOOLS OF NEVAD

Provider Business Mailing Address
First Line	:	3720 HOWARD HUGHES PKWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-0937
Country	:	US
Telephone Number	:	702-770-7611
Fax Number	:	815-550-1534

Provider Business Practice Location Address
First Line	:	4145 JIMMY DURANTE BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-5431
Country	:	US
Telephone Number	:	702-855-9675
Fax Number	:

Authorized Official
Title or Position	:	STATE DIRECTOR
Name	:	LOUISE HELTON
Credential	:
Telephone Number	:	702-590-5330

Provider Enumeration Date	:	02/05/2010
Last Update Date	:	02/05/2010

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Directions to “COMMUNITIES IN SCHOOLS OF NEVAD ” Practice Location

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