MEDICARE: MR PROPERTIES 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
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1871975201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MR PROPERTIES INC

Provider Business Mailing Address
First Line	:	5482 WILSHIRE BLVD
Second Line	:	1573
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-4218
Country	:	US
Telephone Number	:	323-540-8091
Fax Number	:

Provider Business Practice Location Address
First Line	:	861 N BRUCE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-2162
Country	:	US
Telephone Number	:	323-540-8091
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL ARTAVIA
Credential	:
Telephone Number	:	323-540-8091

Provider Enumeration Date	:	06/22/2015
Last Update Date	:	06/22/2015

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Directions to “MR PROPERTIES INC ” Practice Location

Language	Start Address	Practice Location

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