MEDICARE: KAM LEARNING CAMPUS LLC

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	:	1316619745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAM LEARNING CAMPUS LLC

Provider Business Mailing Address
First Line	:	165 ALAMERE FALLS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-6156
Country	:	US
Telephone Number	:	702-400-1720
Fax Number	:

Provider Business Practice Location Address
First Line	:	3140 S RAINBOW BLVD STE 400
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6234
Country	:	US
Telephone Number	:	702-400-1720
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MR. GARY SORESMAN
Credential	:
Telephone Number	:	702-400-1720

Provider Enumeration Date	:	10/04/2021
Last Update Date	:	10/04/2021

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Directions to “KAM LEARNING CAMPUS LLC ” Practice Location

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