MEDICARE: HONNE B CARE, INC.

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	:	1780879635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HONNE B CARE, INC.

Provider Business Mailing Address
First Line	:	6861 PHILIPPE ALLEN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-5240
Country	:	US
Telephone Number	:	702-275-5214
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 BETTY LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-1601
Country	:	US
Telephone Number	:	702-459-3700
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MS. TERRI BROOKS
Credential	:
Telephone Number	:	702-275-5214

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	09/12/2007

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