MEDICARE: HEALTHY HUGS 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	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1770006447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY HUGS BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	6500 VEGAS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-7707
Country	:	US
Telephone Number	:	949-600-0754
Fax Number	:

Provider Business Practice Location Address
First Line	:	6500 VEGAS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-7707
Country	:	US
Telephone Number	:	949-600-0754
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. LASHAWNE FLUCKER
Credential	:
Telephone Number	:	949-600-0754

Provider Enumeration Date	:	07/24/2017
Last Update Date	:	07/21/2022

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