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NPI Code Detail

MEDICARE: ADVANCE PROFESSIONAL BEHAVIORAL SERVICES

MEDICARE: ADVANCE PROFESSIONAL BEHAVIORAL SERVICES
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1871091769
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCE PROFESSIONAL BEHAVIORAL SERVICES
Provider Business Mailing Address
First Line : 1351 W OWENS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2432
Country : US
Telephone Number : 702-636-3900
Fax Number :
Provider Business Practice Location Address
First Line : 1351 W OWENS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2432
Country : US
Telephone Number : 702-636-3900
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MAURICE THOMAS
Credential :
Telephone Number : 702-636-3900
Provider Enumeration Date : 01/25/2018
Last Update Date : 01/25/2018

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Directions to “ADVANCE PROFESSIONAL BEHAVIORAL SERVICES ” Practice Location

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