MEDICARE: REM 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	225XP0200X	Pediatric Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1538318472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REM NEVADA

Provider Business Mailing Address
First Line	:	5693 S JONES BLVD STE 118
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1967
Country	:	US
Telephone Number	:	702-889-9240
Fax Number	:	702-889-6945

Provider Business Practice Location Address
First Line	:	5693 S JONES BLVD STE 118
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1967
Country	:	US
Telephone Number	:	702-889-9240
Fax Number	:	702-889-6945

Authorized Official
Title or Position	:	A/R SUPERVISOR
Name	:	MS. DOREEN CASTEL
Credential	:
Telephone Number	:	702-889-9240

Provider Enumeration Date	:	09/16/2008
Last Update Date	:	09/16/2008

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Directions to “REM NEVADA ” Practice Location

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