MEDICARE: ENRICHMENT CENTER LLC

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	101Y00000X	Counselor
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1134050404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENRICHMENT CENTER LLC

Provider Business Mailing Address
First Line	:	2860 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5271
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5271
Country	:	US
Telephone Number	:	702-886-0828
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	KATIE SHIELDS
Credential	:
Telephone Number	:	702-328-6286

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ENRICHMENT CENTER LLC ” Practice Location

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