MEDICARE: URBAN SOCIAL SERVICES CORP

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	1041C0700X	Clinical Social Worker	5341-C	NV

General Provider Information

NPI Number	:	1982833778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URBAN SOCIAL SERVICES CORP

Provider Business Mailing Address
First Line	:	2350 S JONES BLVD
Second Line	:	SUITE 227
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3103
Country	:	US
Telephone Number	:	702-214-2140
Fax Number	:	702-215-5801

Provider Business Practice Location Address
First Line	:	2350 S JONES BLVD
Second Line	:	SUITE 227
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3103
Country	:	US
Telephone Number	:	702-214-2140
Fax Number	:	702-215-5801

Authorized Official
Title or Position	:	OWNER
Name	:	JERRY STEELE
Credential	:
Telephone Number	:	702-214-2140

Provider Enumeration Date	:	07/14/2009
Last Update Date	:	08/14/2009

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