MEDICARE: ALEXIS EUBANKS

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		NV

General Provider Information

NPI Number	:	1184153488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS EUBANKS

Provider Business Mailing Address
First Line	:	5301 RIVER GLEN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-5282
Country	:	US
Telephone Number	:	213-858-2019
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 RIVER GLEN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-5282
Country	:	US
Telephone Number	:	213-858-2019
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	07/21/2022

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Directions to “ ALEXIS EUBANKS ” Practice Location

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