MEDICARE: FUTURE FOUNDATION SERVICES

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	251B00000X	Case Management Agency
2	302F00000X	Exclusive Provider Organization

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	:	1508228180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUTURE FOUNDATION SERVICES

Provider Business Mailing Address
First Line	:	3230 S BUFFALO RD STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117
Country	:	US
Telephone Number	:	702-445-0819
Fax Number	:

Provider Business Practice Location Address
First Line	:	3230 S BUFFALO RD STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117
Country	:	US
Telephone Number	:	702-445-0819
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MR. FREDIA C RICE
Credential	:
Telephone Number	:	702-445-0819

Provider Enumeration Date	:	03/23/2016
Last Update Date	:	03/23/2016

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