MEDICARE: A LOVING TOUCH BEHAVIORAL HEALTH SERVICES, INC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1356627376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A LOVING TOUCH BEHAVIORAL HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	2608 WHITE OAK RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-5341
Country	:	US
Telephone Number	:	702-622-5526
Fax Number	:

Provider Business Practice Location Address
First Line	:	2608 WHITE OAK RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-5341
Country	:	US
Telephone Number	:	702-622-5526
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENTS
Name	:	CAREY RODGERS
Credential	:
Telephone Number	:	702-622-5526

Provider Enumeration Date	:	10/24/2011
Last Update Date	:	10/24/2011

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