Healthcare Provider Details

I. General information

NPI: 1174064786
Provider Name (Legal Business Name): DR. MIRIAM & SHELDON G ADELSON CLINIC FOR DRUG ABUSE TREATMENT & RESEA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 S MARYLAND PKWY STE 64
LAS VEGAS NV
89169-3003
US

IV. Provider business mailing address

3661 S MARYLAND PKWY STE 64
LAS VEGAS NV
89169-3003
US

V. Phone/Fax

Practice location:
  • Phone: 702-735-7900
  • Fax: 702-735-0081
Mailing address:
  • Phone: 702-735-7900
  • Fax: 702-735-0081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2583NTC-15
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: DINITA SMITH
Title or Position: DIRECTOR
Credential:
Phone: 702-735-7900