MEDICARE: PENSION PLUS LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1902325871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENSION PLUS LLC

Provider Business Mailing Address
First Line	:	PO BOX 752482
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89136-2482
Country	:	US
Telephone Number	:	702-540-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	9401 DARWELL DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-0420
Country	:	US
Telephone Number	:	702-540-9700
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CYNTHIA RANDLE
Credential	:
Telephone Number	:	702-540-9700

Provider Enumeration Date	:	09/12/2017
Last Update Date	:	06/16/2018

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Directions to “PENSION PLUS LLC ” Practice Location

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