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NPI Code Detail

MEDICARE: PRODUCTIVE COMMUNITY SERVICES

MEDICARE: PRODUCTIVE COMMUNITY SERVICES
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
1251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1588222871
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRODUCTIVE COMMUNITY SERVICES
Provider Business Mailing Address
First Line : 1517 SANTA ROSALIA DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-1010
Country : US
Telephone Number : 702-929-3297
Fax Number :
Provider Business Practice Location Address
First Line : 4496 N RANCHO DR STE E1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-3406
Country : US
Telephone Number : 702-929-3297
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : NICHOLE NELSON
Credential :
Telephone Number : 702-929-3297
Provider Enumeration Date : 05/31/2019
Last Update Date : 05/31/2019

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Directions to “PRODUCTIVE COMMUNITY SERVICES ” Practice Location

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