MEDICARE: RITE OF WAYZ 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
1	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1164964862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RITE OF WAYZ BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	5909 VICTORY POINT ST
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89081-3024
Country	:	US
Telephone Number	:	702-817-0372
Fax Number	:

Provider Business Practice Location Address
First Line	:	5909 VICTORY POINT ST
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89081-3024
Country	:	US
Telephone Number	:	702-817-0372
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	RAY GREENE
Credential	:
Telephone Number	:	702-817-0372

Provider Enumeration Date	:	11/11/2016
Last Update Date	:	11/11/2016

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