MEDICARE: OUICAREBEHAVIORALHEALTH 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1497498364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUICAREBEHAVIORALHEALTH INC

Provider Business Mailing Address
First Line	:	1408 ANDREW DAVID AVE
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89086-1347
Country	:	US
Telephone Number	:	702-462-0135
Fax Number	:

Provider Business Practice Location Address
First Line	:	1408 ANDREW DAVID AVE
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89086-1347
Country	:	US
Telephone Number	:	702-462-0135
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RICKY J SPANN
Credential	:
Telephone Number	:	757-788-1290

Provider Enumeration Date	:	04/18/2022
Last Update Date	:	04/18/2022

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