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NPI Code Detail

MEDICARE: DONALD POSSON, PH.D., LADC

MEDICARE: DONALD POSSON, PH.D., LADC
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center1082NV

General Provider Information

NPI Number : 1568896736
Entity Type Code : Organization
Provider Name (Legal Business Name) : DONALD POSSON, PH.D., LADC
Provider Business Mailing Address
First Line : 8275 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2591
Country : US
Telephone Number : 702-684-1455
Fax Number :
Provider Business Practice Location Address
First Line : 5655 INDIAN SPRINGS ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-5079
Country : US
Telephone Number : 702-684-1455
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. DONALD POSSON
Credential : PH.D., LADC
Telephone Number : 702-684-1455
Provider Enumeration Date : 08/24/2013
Last Update Date : 08/24/2013

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