MEDICARE: FAMILY EMPOWEEMENT ACADEMY OF NEVADA

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

General Provider Information

NPI Number	:	1497528855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY EMPOWEEMENT ACADEMY OF NEVADA

Provider Business Mailing Address
First Line	:	3910 PECOS MCLEOD STE A100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7441
Country	:	US
Telephone Number	:	702-612-7486
Fax Number	:

Provider Business Practice Location Address
First Line	:	3910 PECOS MCLEOD STE A100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7441
Country	:	US
Telephone Number	:	702-612-7486
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. AHMID SMITH
Credential	:
Telephone Number	:	702-612-7486

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	11/06/2023

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