MEDICARE: SPECIAL EMPLOYMENT SERVICES, INC.

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	251C00000X	Developmentally Disabled Services Day Training Agency

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	:	1972797041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIAL EMPLOYMENT SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 81166
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89180-1166
Country	:	US
Telephone Number	:	702-877-0650
Fax Number	:	702-363-9381

Provider Business Practice Location Address
First Line	:	5726 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1236
Country	:	US
Telephone Number	:	702-877-0650
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. ROBERT SAUNDERS
Credential	:	CRC
Telephone Number	:	702-595-1359

Provider Enumeration Date	:	08/31/2007
Last Update Date	:	08/31/2007

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