MEDICARE: NEVADA PARTNERSHIP FOR HOMELESS YOUTH

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	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1457809345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA PARTNERSHIP FOR HOMELESS YOUTH

Provider Business Mailing Address
First Line	:	4981 SHIRLEY ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4822
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4981 SHIRLEY ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4822
Country	:	US
Telephone Number	:	702-383-1332
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ARASH GHAFOORI
Credential	:
Telephone Number	:	702-383-1332

Provider Enumeration Date	:	09/20/2016
Last Update Date	:	09/20/2016

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