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NPI Code Detail

MEDICARE: HOME OF POSSIBILITIES

MEDICARE: HOME OF POSSIBILITIES
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
1251K00000XPublic Health or Welfare Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730545112
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOME OF POSSIBILITIES
Provider Business Mailing Address
First Line : 400 S 4TH ST STE 500
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-6207
Country : US
Telephone Number : 702-793-4233
Fax Number :
Provider Business Practice Location Address
First Line : 400 S 4TH ST STE 500
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-6207
Country : US
Telephone Number : 702-793-4233
Fax Number :
Authorized Official
Title or Position : CEO
Name : CORY RON BIENIEMY
Credential :
Telephone Number : 619-549-7044
Provider Enumeration Date : 01/14/2016
Last Update Date : 01/14/2016

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1912057191 — COURTNEY G LUPIA BLASI RN, WHNP
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1831639137 — KRISTINA BENNETT
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Directions to “HOME OF POSSIBILITIES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.