MEDICARE: A PLACE CALLED HOME

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	251B00000X	Case Management Agency	NV
2	251S00000X	Community/Behavioral Health Agency	NV
3	302F00000X	Exclusive Provider Organization	NV
4	251V00000X	Voluntary or Charitable Agency	NV

General Provider Information

NPI Number	:	1023414232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A PLACE CALLED HOME

Provider Business Mailing Address
First Line	:	3752 BOSSA NOVA DR
Second Line	:	3308 SALMON CREEK
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6800
Country	:	US
Telephone Number	:	702-381-4774
Fax Number	:

Provider Business Practice Location Address
First Line	:	3308 SALMON CREEK DR
Second Line	:	3752 BOSSA NOVA DR
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6186
Country	:	US
Telephone Number	:	702-381-4774
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	APRL CELESTE ARAQUIL
Credential	:
Telephone Number	:	702-381-4774

Provider Enumeration Date	:	11/16/2014
Last Update Date	:	03/24/2016

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Directions to “A PLACE CALLED HOME ” Practice Location

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