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NPI Code Detail

MEDICARE: EXPRESSIONS BEHAVIORAL HEALTH

MEDICARE: EXPRESSIONS BEHAVIORAL HEALTH
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
1251B00000XCase Management AgencyCA
2251B00000XCase Management Agency5770-CNV

General Provider Information

NPI Number : 1063741320
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXPRESSIONS BEHAVIORAL HEALTH
Provider Business Mailing Address
First Line : 2475 W CHEYENNE AVE
Second Line : SUITE 170
City : NORTH LAS VEGAS
State : NV
Zip : 89032-4327
Country : US
Telephone Number : 702-619-6237
Fax Number :
Provider Business Practice Location Address
First Line : 2475 W CHEYENNE AVE
Second Line : SUITE 170
City : NORTH LAS VEGAS
State : NV
Zip : 89032-4327
Country : US
Telephone Number : 702-619-6237
Fax Number :
Authorized Official
Title or Position : CEO
Name : ALI-JAI FAISON
Credential : PRESIDENT
Telephone Number : 702-619-6237
Provider Enumeration Date : 12/16/2009
Last Update Date : 03/26/2015

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1538583075 — EVELYN STEWART
Practice Location Address:
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Practice Fax: 888-959-8990

Directions to “EXPRESSIONS BEHAVIORAL HEALTH ” Practice Location

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