MEDICARE: INFINITY LIFE RESOURCE CENTERS

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	NV20161185819	NV

General Provider Information

NPI Number	:	1851745509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITY LIFE RESOURCE CENTERS

Provider Business Mailing Address
First Line	:	2150 N TENAYA WAY
Second Line	:	1089
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0402
Country	:	US
Telephone Number	:	702-747-0144
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 N TENAYA WAY
Second Line	:	1089
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0402
Country	:	US
Telephone Number	:	702-747-0144
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	MS. JOY A HARRIS
Credential	:
Telephone Number	:	702-747-0144

Provider Enumeration Date	:	04/19/2016
Last Update Date	:	04/19/2016

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