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General NPI Number Information
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NPI Number | 1588703698
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Entity Type | Organization
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Legal Business Name | DR MIRIAM & SHELDON G ADELSON CLINIC OF DRUG ABUSE TREATMENT & RESEARC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 3661 S MARYLAND PKWY SUITE 64
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City | LAS VEGAS
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State | NV
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Zip | 89169
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Country | US
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Telephone | 702-735-0081
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Fax |
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Provider Business Mailing Address
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Address Line | 3661 S MARYLAND PKWY SUITE 64
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City | LAS VEGAS
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State | NV
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Zip | 89169
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Country | US
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Telephone | 702-735-0081
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | MRS. SHIRLEY LINZY
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Credential | RN MS
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Telephone | 702-735-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LA0401X
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Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
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License Number | 2583NTC8
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207LA0401X
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Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
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License Number | RA0254209
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License Number State | NV
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