MEDICARE: FROM THE HEART

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	:	1992055917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FROM THE HEART

Provider Business Mailing Address
First Line	:	6955 N DURANGO DR STE 1115-718
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4411
Country	:	US
Telephone Number	:	702-353-1786
Fax Number	:	702-965-2455

Provider Business Practice Location Address
First Line	:	6955 N DURANGO DR STE 1115-718
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4411
Country	:	US
Telephone Number	:	702-353-1786
Fax Number	:	702-965-2455

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. MARY C TORY
Credential	:
Telephone Number	:	702-353-1786

Provider Enumeration Date	:	09/17/2012
Last Update Date	:	09/17/2012

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Directions to “FROM THE HEART ” Practice Location

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