Provider Demographics
NPI:1225294648
Name:PITTMAN AND PITTMAN ENTERPRISES
Entity Type:Organization
Organization Name:PITTMAN AND PITTMAN ENTERPRISES
Other - Org Name:NEW BEGINNINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FEMIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:702-813-8301
Mailing Address - Street 1:6935 ALIANTE PKWY
Mailing Address - Street 2:SUITE 104-226
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-5818
Mailing Address - Country:US
Mailing Address - Phone:702-813-8301
Mailing Address - Fax:
Practice Address - Street 1:6935 ALIANTE PKWY
Practice Address - Street 2:SUITE 104-226
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-5818
Practice Address - Country:US
Practice Address - Phone:702-813-8301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV34Medicaid