MEDICARE: FIELDS OF WELLNESS HOMES

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	1001986083	NV
2	101YP1600X	Pastoral Counselor	1001986083	NV
3	103T00000X	Psychologist	1001986083	NV
4	103TA0400X	Addiction (Substance Use Disorder) Psychologist	1001986083	NV
5	103TH0004X	Health Psychologist	1001986083	NV
6	103TH0100X	Health Service Psychologist	1001986083	NV
7	103TP0814X	Psychoanalysis Psychologist	1001986083	NV
8	103TP2701X	Group Psychotherapy Psychologist	1001986083	NV
9	104100000X	Social Worker	1001986083	NV
10	323P00000X	Psychiatric Residential Treatment Facility	1001986083	NV
11	103TF0000X	Family Psychologist	1001986083	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174757611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIELDS OF WELLNESS HOMES

Provider Business Mailing Address
First Line	:	1529 DUHAMEL WAY
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-7937
Country	:	US
Telephone Number	:	702-813-6573
Fax Number	:

Provider Business Practice Location Address
First Line	:	1529 DUHAMEL WAY
Second Line	:	1529 DUHAMEL WAY
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-7937
Country	:	US
Telephone Number	:	702-813-6573
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	MRS. PATRICIA GAIL CALDWELL
Credential	:
Telephone Number	:	702-813-6573

Provider Enumeration Date	:	05/12/2009
Last Update Date	:	05/12/2009

Similar Medicare Providers

1902030349 — MRS. PATRICIA GAIL CALDWELL
Practice Location Address:

1529 DUHAMEL WAY
NORTH LAS VEGAS, NV
89032-7937

Practice Phone: 702-813-6573
Practice Fax:

1679801245 — FIELDS OF WELLNESS HOMES INC
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1205899689 — DONALD I KUZYK DPM
Practice Location Address:

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1477638468 — DONALD I KUZYK DPM INC
Practice Location Address:

7937 LILY TROTTER ST
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1760781298 — JAMES VEGARA
Practice Location Address:

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1134691876 — TEAM CRISIS USA
Practice Location Address:

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Directions to “FIELDS OF WELLNESS HOMES ” Practice Location

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