MEDICARE: FAMILY AND CHILD TREATMENT OF SOUTHERN NEVADA

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

General Provider Information

NPI Number	:	1245384908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY AND CHILD TREATMENT OF SOUTHERN NEVADA

Provider Business Mailing Address
First Line	:	1050 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-6231
Country	:	US
Telephone Number	:	702-258-5855
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-6231
Country	:	US
Telephone Number	:	702-258-5855
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. FRAN MARSHALL
Credential	:
Telephone Number	:	702-258-5855

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	08/22/2020

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