MEDICARE: A NEW GENERATION LIFE SKILLS

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	NV20101749146	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447596150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A NEW GENERATION LIFE SKILLS

Provider Business Mailing Address
First Line	:	8225 W SAHARA AVE STE H
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8929
Country	:	US
Telephone Number	:	702-476-2899
Fax Number	:	702-476-1575

Provider Business Practice Location Address
First Line	:	8225 W SAHARA AVE STE H
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8929
Country	:	US
Telephone Number	:	702-476-2899
Fax Number	:	702-476-1575

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIE INGUANZO
Credential	:
Telephone Number	:	702-217-7683

Provider Enumeration Date	:	12/27/2012
Last Update Date	:	07/21/2022

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Directions to “A NEW GENERATION LIFE SKILLS ” Practice Location

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