MEDICARE: MAGNETIC PATHWAYS 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	5151-C	NV

General Provider Information

NPI Number	:	1326469990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGNETIC PATHWAYS LLC

Provider Business Mailing Address
First Line	:	5820 S PECOS RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-5431
Country	:	US
Telephone Number	:	702-336-5964
Fax Number	:	702-586-7291

Provider Business Practice Location Address
First Line	:	5820 S PECOS RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-5431
Country	:	US
Telephone Number	:	702-336-5964
Fax Number	:	702-586-7291

Authorized Official
Title or Position	:	OWNER
Name	:	MS. NANCY E FAYE
Credential	:	MSW
Telephone Number	:	702-336-5964

Provider Enumeration Date	:	12/26/2013
Last Update Date	:	12/26/2013

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