NPI 1053879247 · live from the CMS NPI Registry
Advance Addiction Treatment Center
Counselor, Addiction (Substance Use Disorder) in Las Vegas, NV. National Provider Identifier 1053879247, active.
NPI record
| NPI | 1053879247 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Addiction (Substance Use Disorder) 101YA0400X |
| Practice location | 3130 S Rainbow Blvd Ste 304, Las Vegas, NV 89146 |
| Practice phone | 702-776-2482 |
| Mailing address | 7040 Laredo St Ste E, Las Vegas, NV 89117 |
| Enumerated | March 6, 2019 |
| Last updated | March 28, 2019 |
| Authorized official | Edward Gamboa, Ceo |
| Other names | Aa Treatment Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intermediate Care Facility, Mental Illness | 310500000X | — |
| Social Worker | 104100000X | — |
| Rehabilitation Counselor | 225C00000X | — |
| Community/Behavioral Health | 251S00000X | — |
| Clinic/Center, Adult Mental Health | 261QM0850X | — |
| Clinic/Center, Adolescent and Children Mental Health | 261QM0855X | — |
| Clinic/Center, Rehabilitation, Substance Use Disorder | 261QR0405X | — |
| Clinic/Center, Recovery Care | 261QR0800X | — |
| Counselor, Addiction (Substance Use Disorder) primary | 101YA0400X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.