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General NPI Number Information
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NPI Number | 1053229310
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Entity Type | Organization
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Legal Business Name | CANYON LIGHT TREATMENT, LLC
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 2117 ALTA DR
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City | LAS VEGAS
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State | NV
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Zip | 89106-4808
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Country | US
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Telephone | 702-530-5113
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Fax |
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Provider Business Mailing Address
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Address Line | 3005 LANTERN LN
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City | LAS VEGAS
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State | NV
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Zip | 89107-3229
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Country | US
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Telephone | 702-530-5113
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | STEPHANIE LOREN MAPULA-MAGDALENO
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Credential | CPC, LCADC
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Telephone | 702-782-8829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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