MEDICARE: XL BEHAVIORAL HEALTH SERVICES 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
2	251S00000X	Community/Behavioral Health Agency	5316-C	NV

General Provider Information

NPI Number	:	1326362930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	XL BEHAVIORAL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	7471 PROUD MEADOWS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-2340
Country	:	US
Telephone Number	:	702-510-3352
Fax Number	:

Provider Business Practice Location Address
First Line	:	2030 E FLAMINGO RD STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0831
Country	:	US
Telephone Number	:	702-510-3352
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMEBER
Name	:	MR. SCOTT L THOMPSON
Credential	:	LCSW
Telephone Number	:	808-780-9117

Provider Enumeration Date	:	03/25/2010
Last Update Date	:	05/10/2019

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