MEDICARE: CHARITY'S PLACE LLC DBA CHARITY'S PLACE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	261QM0850X	Adult Mental Health Clinic/Center
3	347C00000X	Private Vehicle
4	251B00000X	Case Management Agency
5	320800000X	Mental Illness Community Based Residential Treatment Facility
6	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
7	385H00000X	Respite Care
8	171M00000X	Case Manager/Care Coordinator
9	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1922964139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARITY'S PLACE LLC DBA CHARITY'S PLACE

Provider Business Mailing Address
First Line	:	2109 WENGERT AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-2033
Country	:	US
Telephone Number	:	702-954-4061
Fax Number	:	702-954-4061

Provider Business Practice Location Address
First Line	:	2109 WENGERT AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-2033
Country	:	US
Telephone Number	:	702-954-4061
Fax Number	:	702-954-4061

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CHARITY WHITE
Credential	:	MPA
Telephone Number	:	702-954-4061

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	03/27/2026

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Directions to “CHARITY'S PLACE LLC DBA CHARITY'S PLACE ” Practice Location

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