Healthcare Provider Details
I. General information
NPI: 1154637429
Provider Name (Legal Business Name): MISSION TREATMENT CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2010
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1536 N BOULDER HWY
HENDERSON NV
89011-4120
US
IV. Provider business mailing address
6183 PASEO DEL NORTE STE 200
CARLSBAD CA
92011-1151
US
V. Phone/Fax
- Phone: 702-558-8600
- Fax: 702-558-8700
- Phone: 760-710-0819
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2800X |
| Taxonomy | Methadone Clinic |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
PHILLIP
FARLEY
Title or Position: VP & SECRETARY
Credential:
Phone: 615-716-9335