MEDICARE: CHILDREN AND ADOLESCENT MENTORING SERVICES

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1114638517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN AND ADOLESCENT MENTORING SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 33096
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-3096
Country	:	US
Telephone Number	:	702-285-4051
Fax Number	:	888-725-8902

Provider Business Practice Location Address
First Line	:	8275 S EASTERN AVE STE 119
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2544
Country	:	US
Telephone Number	:	702-285-4051
Fax Number	:	888-725-8902

Authorized Official
Title or Position	:	CONTROLLER
Name	:	SONYA RENAE JACKSON-HUDDLESTON
Credential	:
Telephone Number	:	702-285-4051

Provider Enumeration Date	:	12/07/2022
Last Update Date	:	12/07/2022

Similar Medicare Providers

1912618216 — YVETTE WALKER-WITHERSPOON
Practice Location Address:

8275 S EASTERN AVE STE 119
LAS VEGAS, NV
89123-2544

Practice Phone: 562-415-4620
Practice Fax: 888-725-8902

1528861465 — MRS. ALLISON LEE BLAKE THOMPSON
Practice Location Address:

8275 S EASTERN AVE STE 127
LAS VEGAS, NV
89123-2544

Practice Phone: 772-775-4685
Practice Fax:

1205728045 — JESSICA LYNN ALDENDORF
Practice Location Address:

8275 S EASTERN AVE STE 127
LAS VEGAS, NV
89123-2544

Practice Phone: 702-850-2500
Practice Fax: 702-846-2511

1043329162 — DR. SONTUSS BUSSARATID M.D.
Practice Location Address:

2121 LAS VEGAS BLVD S
LAS VEGAS, NV
89104-2544

Practice Phone: 702-486-5750
Practice Fax: 702-486-5769

1467573394 — RICHARD HILLIER
Practice Location Address:

2121 LAS VEGAS BLVD S
LAS VEGAS, NV
89104-2544

Practice Phone: 702-486-5750
Practice Fax:

1952185779 — MOUNTAIN CARE LLC
Practice Location Address:

1919 H ST APT C
LAS VEGAS, NV
89106-2544

Practice Phone: 725-251-3362
Practice Fax: 702-549-1915

Directions to “CHILDREN AND ADOLESCENT MENTORING SERVICES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.