Healthcare Provider Details

I. General information

NPI: 1720853005
Provider Name (Legal Business Name): NOBEL TREATMENT AND BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3399 S EASTERN AVE
LAS VEGAS NV
89169-3312
US

IV. Provider business mailing address

3399 S EASTERN AVE
LAS VEGAS NV
89169-3312
US

V. Phone/Fax

Practice location:
  • Phone: 702-444-0438
  • Fax:
Mailing address:
  • Phone: 702-444-0438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GUADALUPE AVILA
Title or Position: OFFICE MANAGER
Credential:
Phone: 702-324-0315