MEDICARE: SAFE SANCTUARIES FOR CHILDREN AND YOUTH

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	225400000X	Rehabilitation Practitioner	NV20131576900	NV

General Provider Information

NPI Number	:	1942600200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFE SANCTUARIES FOR CHILDREN AND YOUTH

Provider Business Mailing Address
First Line	:	5840 W CRAIG RD STE 120-373
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-2561
Country	:	US
Telephone Number	:	702-706-4902
Fax Number	:

Provider Business Practice Location Address
First Line	:	6272 HIGHLAND GARDENS DR
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2074
Country	:	US
Telephone Number	:	702-706-4902
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES FRENCH
Credential	:
Telephone Number	:	702-706-4902

Provider Enumeration Date	:	08/23/2014
Last Update Date	:	08/23/2014

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