Individual ProviderFantanesh AngawSocial WorkerBehavioral Health & Social Service ProvidersPractice Address7368 N Decatur Blvd, Unit 3, Las Vegas, NV 89131-3070(702) 251-8000(702) 630-3458PECOS EnrollmentBased on the most recent information from CMS, provider Fantanesh Angaw is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:14 PM.Profile DetailsProvider ID1326474289Provider TypeIndividualFull NameAngaw, FantaneshGenderFemaleSole ProprietorYesEnumeration Date9/23/2013Last Updated5/9/2022Contact InformationPractice LocationPractice Address7368 N Decatur Blvd, Unit 3, Las Vegas, NV 89131-3070Phone(702) 251-8000FaxUnlisted FaxMailing LocationMailing Address550 Elm Dr Apt 110, Las Vegas, NV 89169-3617Phone(702) 630-3458FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense8644-CNevadaCode103K00000XDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID8644-CDescriptionOtherIssuerLCSWNevada