MEDICARE: THAMES BEHAVIORAL HEALTH & CONSULTING FIRM

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1659753440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THAMES BEHAVIORAL HEALTH & CONSULTING FIRM

Provider Business Mailing Address
First Line	:	5004 CHARLO DR
Second Line	:	STE A
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-3673
Country	:	US
Telephone Number	:	702-808-0486
Fax Number	:

Provider Business Practice Location Address
First Line	:	5004 CHARLO DR
Second Line	:	STE A
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-3673
Country	:	US
Telephone Number	:	702-808-0486
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DARREN LONELL THAMES
Credential	:
Telephone Number	:	702-808-0486

Provider Enumeration Date	:	06/29/2015
Last Update Date	:	06/29/2015

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