MEDICARE: ML CONSULTING, 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	251S00000X	Community/Behavioral Health Agency	E06538220090	NV

General Provider Information

NPI Number	:	1366727430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ML CONSULTING, INC

Provider Business Mailing Address
First Line	:	626 S 9TH ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-7013
Country	:	US
Telephone Number	:	702-386-6001
Fax Number	:	702-386-6003

Provider Business Practice Location Address
First Line	:	626 S 9TH ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-7013
Country	:	US
Telephone Number	:	702-386-6001
Fax Number	:	702-386-6003

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARCUS LIGON
Credential	:
Telephone Number	:	702-271-6643

Provider Enumeration Date	:	10/20/2011
Last Update Date	:	10/20/2011

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