MEDICARE: RE-START CENTER 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1316769094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RE-START CENTER LLC

Provider Business Mailing Address
First Line	:	3601 W SAHARA AVE STE 210
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5821
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 W SAHARA AVE STE 210
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5821
Country	:	US
Telephone Number	:	702-782-9464
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MONICA BLAKNEY-MERCER
Credential	:
Telephone Number	:	702-791-9000

Provider Enumeration Date	:	10/24/2024
Last Update Date	:	11/04/2025

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Directions to “RE-START CENTER LLC ” Practice Location

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