MEDICARE: TOGETHER WE STAND BEHAVIORAL HEALTH

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1760908719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOGETHER WE STAND BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	2110 LOS FELIZ ST UNIT 2072
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89156-8026
Country	:	US
Telephone Number	:	702-808-9204
Fax Number	:	702-992-0326

Provider Business Practice Location Address
First Line	:	2110 N LOS FELIZ ST #2072
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89156
Country	:	US
Telephone Number	:	702-808-9204
Fax Number	:	702-992-0326

Authorized Official
Title or Position	:	OWNER
Name	:	MARLISHA BILLS
Credential	:
Telephone Number	:	702-808-9204

Provider Enumeration Date	:	08/21/2017
Last Update Date	:	07/21/2022

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