MEDICARE: AMAZING MINDS AUTISM CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106E00000X	Assistant Behavior Analyst
2	106S00000X	Behavior Technician
3	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1295577930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAZING MINDS AUTISM CENTER

Provider Business Mailing Address
First Line	:	1342 MELVILLE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1824
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1342 MELVILLE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1824
Country	:	US
Telephone Number	:	305-497-4529
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAZMIN OLIVERA
Credential	:
Telephone Number	:	305-497-4529

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	06/12/2024

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Directions to “AMAZING MINDS AUTISM CENTER ” Practice Location

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