MEDICARE: SISTERS CHOICE INCORPORATED

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	NV20181223223	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952806176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SISTERS CHOICE INCORPORATED

Provider Business Mailing Address
First Line	:	5724 RED ROOF ST
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89081-2440
Country	:	US
Telephone Number	:	702-808-2650
Fax Number	:

Provider Business Practice Location Address
First Line	:	5724 RED ROOF ST
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89081-2440
Country	:	US
Telephone Number	:	702-808-2650
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ERICA PAYTON
Credential	:
Telephone Number	:	702-808-2650

Provider Enumeration Date	:	03/28/2018
Last Update Date	:	06/16/2018

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Directions to “SISTERS CHOICE INCORPORATED ” Practice Location

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