MEDICARE: TURNING TABLES

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	251B00000X	Case Management Agency		NV

General Provider Information

NPI Number	:	1801332705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TURNING TABLES

Provider Business Mailing Address
First Line	:	5423 SUNNYVILLE ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-7986
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5423 SUNNYVILLE ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-7986
Country	:	US
Telephone Number	:	469-422-9364
Fax Number	:

Authorized Official
Title or Position	:	ORGANIZATION DIRECTOR
Name	:	APRIL KINDLE
Credential	:
Telephone Number	:	469-422-9364

Provider Enumeration Date	:	01/16/2017
Last Update Date	:	01/16/2017

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