MEDICARE: SIARRA SLIFE

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	106S00000X	Behavior Technician	RBT6168	NV

General Provider Information

NPI Number	:	1447103668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIARRA SLIFE

Provider Business Mailing Address
First Line	:	8928 HAPPY STREAM AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143-4477
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	871 CORONADO CENTER DR STE 200
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3977
Country	:	US
Telephone Number	:	702-725-0544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “ SIARRA SLIFE ” Practice Location

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