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NPI Code Detail

MEDICARE: DR. MIRIAM & SHELDON G ADELSON CLINIC FOR DRUG ABUSE TREATMENT & RESEA

MEDICARE: DR. MIRIAM & SHELDON G ADELSON CLINIC FOR DRUG ABUSE TREATMENT & RESEA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2800XMethadone Clinic
2101YA0400XAddiction (Substance Use Disorder) Counselor2583NTC-15NV

General Provider Information

NPI Number : 1174064786
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. MIRIAM & SHELDON G ADELSON CLINIC FOR DRUG ABUSE TREATMENT & RESEA
Provider Business Mailing Address
First Line : 3661 S MARYLAND PKWY
Second Line : STE 64
City : LAS VEGAS
State : NV
Zip : 89169-3003
Country : US
Telephone Number : 702-735-7900
Fax Number : 702-735-0081
Provider Business Practice Location Address
First Line : 3661 S MARYLAND PKWY
Second Line : STE 64
City : LAS VEGAS
State : NV
Zip : 89169-3003
Country : US
Telephone Number : 702-735-7900
Fax Number : 702-735-0081
Authorized Official
Title or Position : DIRECTOR
Name : DINITA SMITH
Credential :
Telephone Number : 702-735-7900
Provider Enumeration Date : 03/15/2017
Last Update Date : 03/27/2024

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