MEDICARE: HEALING ANGELS BEHAVIORAL HEALTH SERVICE

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	NV20181532283	NV

General Provider Information

NPI Number	:	1912486564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING ANGELS BEHAVIORAL HEALTH SERVICE

Provider Business Mailing Address
First Line	:	4214 PALAMOS DR
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-2621
Country	:	US
Telephone Number	:	702-423-7133
Fax Number	:

Provider Business Practice Location Address
First Line	:	4214 PALAMOS DRIVE NORTH LAS VEGAS, NV 89032
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-8903
Country	:	US
Telephone Number	:	702-423-7133
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL WESTBROOK
Credential	:
Telephone Number	:	702-423-7133

Provider Enumeration Date	:	08/13/2018
Last Update Date	:	08/17/2018

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Directions to “HEALING ANGELS BEHAVIORAL HEALTH SERVICE ” Practice Location

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