MEDICARE: EVER BRAVE TREATMENT CENTERS

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
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1194587576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVER BRAVE TREATMENT CENTERS

Provider Business Mailing Address
First Line	:	370 E 1375 S
Second Line	:
City	:	KAYSVILLE
State	:	UT
Zip	:	84037-3074
Country	:	US
Telephone Number	:	801-414-4250
Fax Number	:

Provider Business Practice Location Address
First Line	:	8689 W SAHARA AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5871
Country	:	US
Telephone Number	:	702-330-5665
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LYNNE SILL
Credential	:	LCSW
Telephone Number	:	801-414-4250

Provider Enumeration Date	:	01/30/2024
Last Update Date	:	09/11/2024

Similar Medicare Providers

1699055061 — LYNNE SILL
Practice Location Address:

8689 W SAHARA AVE STE 100
LAS VEGAS, NV
89117-5871

Practice Phone: 702-330-5665
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1639157720 — DR. JEYLAN A EL-MANSOURY MD
Practice Location Address:

5871 W CRAIG RD
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89130-2575

Practice Phone: 702-724-2020
Practice Fax: 702-724-2800

1619957081 — EVA I LIANG MD
Practice Location Address:

5871 W. CRAIG RD.
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89130-2575

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1639135288 — JIMMY G RAMOS P.A.
Practice Location Address:

2670 N LAS VEGAS BLVD , SUITE 109
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Practice Phone: 702-399-0604
Practice Fax: 702-399-0607

1083672539 — DR. JEFFREY L. HART MD
Practice Location Address:

5871 W. CRAIG RD.
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89130-2575

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1790896660 — WALTER REED JAUSSI MD
Practice Location Address:

5871 W CRAIG RD
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89130-2575

Practice Phone: 702-724-2020
Practice Fax: 702-724-2800

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