MEDICARE: HEIDI SUE UNGER

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	385H00000X	Respite Care		NV

General Provider Information

NPI Number	:	1093178832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEIDI SUE UNGER

Provider Business Mailing Address
First Line	:	14050 KYLE CANYON RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-1338
Country	:	US
Telephone Number	:	702-395-1519
Fax Number	:	702-395-2850

Provider Business Practice Location Address
First Line	:	14050 KYLE CANYON RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-1338
Country	:	US
Telephone Number	:	702-395-1519
Fax Number	:	702-395-2850

Authorized Official
Title or Position	:	OWNER
Name	:	HEIDI SUE UNGER
Credential	:
Telephone Number	:	702-395-1519

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	03/30/2016

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Directions to “HEIDI SUE UNGER ” Practice Location

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