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NPI Code Detail

MEDICARE: SEQUEL ALLIANCE FAMILY SERVICES, LLC

MEDICARE: SEQUEL ALLIANCE FAMILY SERVICES, LLC
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
1101YM0800XMental Health CounselorNV20141007166NV

General Provider Information

NPI Number : 1538581087
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEQUEL ALLIANCE FAMILY SERVICES, LLC
Provider Business Mailing Address
First Line : 1131 EAGLETREE LN SW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35801-6478
Country : US
Telephone Number : 256-880-3339
Fax Number : 256-880-9569
Provider Business Practice Location Address
First Line : 4431 S EASTERN AVE STE 1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7850
Country : US
Telephone Number : 702-750-0377
Fax Number : 702-538-7928
Authorized Official
Title or Position : CBO DIRECTOR OF PATIENT ACCOUNTS
Name : MRS. MARY CAUDLE
Credential :
Telephone Number : 256-880-3339
Provider Enumeration Date : 01/16/2014
Last Update Date : 01/17/2014

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Directions to “SEQUEL ALLIANCE FAMILY SERVICES, LLC ” Practice Location

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