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NPI Code Detail

MEDICARE: KEEPING YOUTH EDUCATED, INC

MEDICARE: KEEPING YOUTH EDUCATED, INC
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
1252Y00000XEarly Intervention Provider Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851717896
Entity Type Code : Organization
Provider Name (Legal Business Name) : KEEPING YOUTH EDUCATED, INC
Provider Business Mailing Address
First Line : 1380 E SILVERADO RANCH BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-5924
Country : US
Telephone Number : 702-453-8877
Fax Number : 702-453-8874
Provider Business Practice Location Address
First Line : 1380 E SILVERADO RANCH BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-5924
Country : US
Telephone Number : 702-453-8877
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : CONNIE L HARRIS
Credential :
Telephone Number : 702-453-8877
Provider Enumeration Date : 03/14/2014
Last Update Date : 04/02/2015

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Directions to “KEEPING YOUTH EDUCATED, INC ” Practice Location

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