MEDICARE: CENTER FOR BEHAVIORAL HEALTH LAS VEGAS LLC

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	261QM2800X	Methadone Clinic	4598NTC-1	NV
2	261QM2800X	Methadone Clinic		NV

General Provider Information

NPI Number	:	1508068271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR BEHAVIORAL HEALTH LAS VEGAS LLC

Provider Business Mailing Address
First Line	:	5001 SPRING VALLEY ROAD
Second Line	:	SUITE 600 EAST
City	:	DALLAS
State	:	TX
Zip	:	75244
Country	:	US
Telephone Number	:	214-365-6100
Fax Number	:	214-365-6150

Provider Business Practice Location Address
First Line	:	3470 W CHEYENNE AVE
Second Line	:	SUITE 400
City	:	LAS VEGAS
State	:	NV
Zip	:	89032-8244
Country	:	US
Telephone Number	:	702-636-0085
Fax Number	:	702-636-0087

Authorized Official
Title or Position	:	CEO
Name	:	MR. JAY HIGHAM
Credential	:
Telephone Number	:	214-365-6100

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	12/26/2024

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