MEDICARE: A HOPE IN NEW BEGINNINGS

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1932302239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A HOPE IN NEW BEGINNINGS

Provider Business Mailing Address
First Line	:	1736 E CHARLESTON
Second Line	:	#264
City	:	LAS VEGAS
State	:	NV
Zip	:	89104
Country	:	US
Telephone Number	:	702-384-4673
Fax Number	:	702-384-3667

Provider Business Practice Location Address
First Line	:	1500 E TROPICANA
Second Line	:	STE 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-8344
Country	:	US
Telephone Number	:	702-384-4673
Fax Number	:	702-384-3667

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JAMES D BASS
Credential	:	PHD
Telephone Number	:	702-384-4673

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	12/07/2007

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