MEDICARE: TRUTH 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
1	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1548760044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUTH FAMILY SERVICES LLC

Provider Business Mailing Address
First Line	:	10631 GIBBOUS MOON DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6493
Country	:	US
Telephone Number	:	804-497-9405
Fax Number	:

Provider Business Practice Location Address
First Line	:	10631 GIBBOUS MOON DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6493
Country	:	US
Telephone Number	:	804-497-9405
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JUAN WILSON
Credential	:
Telephone Number	:	804-497-9405

Provider Enumeration Date	:	02/20/2018
Last Update Date	:	02/20/2018

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Directions to “TRUTH FAMILY SERVICES LLC ” Practice Location

Language	Start Address	Practice Location

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