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NPI Code Detail

MEDICARE: ISU INC

MEDICARE: ISU 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
1251S00000XCommunity/Behavioral Health AgencyNV20041671856NV

General Provider Information

NPI Number : 1528445277
Entity Type Code : Organization
Provider Name (Legal Business Name) : ISU INC
Provider Business Mailing Address
First Line : 1745 N. NELLIS BLVD
Second Line : STE A
City : LAS VEGAS
State : NV
Zip : 89115-3673
Country : US
Telephone Number : 702-459-7500
Fax Number : 702-476-2028
Provider Business Practice Location Address
First Line : 1745 N. NELLIS BLVD
Second Line : STE A
City : LAS VEGAS
State : NV
Zip : 89115-3673
Country : US
Telephone Number : 702-459-7500
Fax Number : 702-459-1176
Authorized Official
Title or Position : PRESIDENT
Name : CHUKA E. HUMPHREYS
Credential : PH.D
Telephone Number : 702-459-7500
Provider Enumeration Date : 05/01/2015
Last Update Date : 05/01/2015

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Directions to “ISU INC ” Practice Location

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