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General NPI Number Information
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NPI Number | 1467265439
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Entity Type | Organization
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Legal Business Name | SILVER STATE ADOLESCENT & TREATMENT CENTER LLC
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 8225 W ROBINDALE RD
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City | LAS VEGAS
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State | NV
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Zip | 89113-3701
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Country | US
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Telephone | 818-928-0038
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Fax |
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Provider Business Mailing Address
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Address Line | 5850 CANOGA AVE STE 130
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6750
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TER-HOVHANNISYAN EDGAR
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Credential |
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Telephone | 818-928-0038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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