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NPI Code Detail

MEDICARE: HALLWAY 2 A HEART

MEDICARE: HALLWAY 2 A 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
1320800000XMental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1992247266
Entity Type Code : Organization
Provider Name (Legal Business Name) : HALLWAY 2 A HEART
Provider Business Mailing Address
First Line : 1313 MISTY VIEW COURT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-1059
Country : US
Telephone Number : 702-904-4097
Fax Number : 702-963-8546
Provider Business Practice Location Address
First Line : 1313 MISTY VIEW COURT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-1059
Country : US
Telephone Number : 702-904-4097
Fax Number : 702-963-8546
Authorized Official
Title or Position : CEO
Name : MISS DANA MICHELLE HALL
Credential : PHYSOCOLGIST
Telephone Number : 702-904-4097
Provider Enumeration Date : 11/17/2016
Last Update Date : 11/17/2016

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Directions to “HALLWAY 2 A HEART ” Practice Location

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