MEDICARE: PEOPLESBEHAVIOR

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	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1750726915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEOPLESBEHAVIOR

Provider Business Mailing Address
First Line	:	1121 W ADAMS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-2946
Country	:	US
Telephone Number	:	702-677-5771
Fax Number	:

Provider Business Practice Location Address
First Line	:	1121 W ADAMS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-2946
Country	:	US
Telephone Number	:	702-677-5771
Fax Number	:

Authorized Official
Title or Position	:	BEHAVIOR SPECIALIST
Name	:	MR. RICKY L PEOPLE
Credential	:
Telephone Number	:	702-834-0868

Provider Enumeration Date	:	05/01/2013
Last Update Date	:	05/01/2013

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Directions to “PEOPLESBEHAVIOR ” Practice Location

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