MEDICARE: FORGE AHEAD 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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1225736101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORGE AHEAD LLC

Provider Business Mailing Address
First Line	:	7536 MOUNT SPOKANE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-5376
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7536 MOUNT SPOKANE CT LOT 10
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-5376
Country	:	US
Telephone Number	:	719-651-7584
Fax Number	:

Authorized Official
Title or Position	:	VP
Name	:	BROOKE SGUARDO
Credential	:
Telephone Number	:	480-299-2385

Provider Enumeration Date	:	02/20/2023
Last Update Date	:	01/27/2026

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Directions to “FORGE AHEAD LLC ” Practice Location

Language	Start Address	Practice Location

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