MEDICARE: I'LL MEET YOU THERE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1609584531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I'LL MEET YOU THERE LLC

Provider Business Mailing Address
First Line	:	6935 ALIANTE PKWY STE 104 #435
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6935 ALIANTE PKWY STE 104
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-5819
Country	:	US
Telephone Number	:	702-849-3178
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEXIS MERCADO-CANTY
Credential	:
Telephone Number	:	702-849-3178

Provider Enumeration Date	:	11/09/2022
Last Update Date	:	03/30/2023

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Directions to “I'LL MEET YOU THERE LLC ” Practice Location

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