MEDICARE: PITTMAN AND PITTMAN ENTERPRISES

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	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility		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	:	1225294648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PITTMAN AND PITTMAN ENTERPRISES

Provider Business Mailing Address
First Line	:	6935 ALIANTE PKWY
Second Line	:	SUITE 104-226
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-5818
Country	:	US
Telephone Number	:	702-813-8301
Fax Number	:

Provider Business Practice Location Address
First Line	:	6935 ALIANTE PKWY
Second Line	:	SUITE 104-226
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-5818
Country	:	US
Telephone Number	:	702-813-8301
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATIVE DIRECTOR
Name	:	MRS. FEMIA D PITTMAN
Credential	:	MPA
Telephone Number	:	702-813-8301

Provider Enumeration Date	:	08/05/2008
Last Update Date	:	08/05/2008

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Directions to “PITTMAN AND PITTMAN ENTERPRISES ” Practice Location

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