MEDICARE: YOUTH BEHAVIORAL HEALTH NETWORK 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	:	1528230042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUTH BEHAVIORAL HEALTH NETWORK OF NEVADA

Provider Business Mailing Address
First Line	:	51 N PECOS RD
Second Line	:	STE. 112
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-4887
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	51 N PECOS RD
Second Line	:	STE. 112
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-4887
Country	:	US
Telephone Number	:	702-837-3788
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KATHY LOVE
Credential	:
Telephone Number	:	702-837-3788

Provider Enumeration Date	:	03/25/2008
Last Update Date	:	03/25/2008

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