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NPI Code Detail

MEDICARE: CONCORDE TREATMENT CENTER, LLC

MEDICARE: CONCORDE TREATMENT CENTER, LLC
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
1261QM0850XAdult Mental Health Clinic/Center7470NV
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center7470NV
3324500000XSubstance Abuse Rehabilitation Facility7470NV

General Provider Information

NPI Number : 1275879199
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONCORDE TREATMENT CENTER, LLC
Provider Business Mailing Address
First Line : 500 WILSON PIKE CIR STE 360
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-3266
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2465 E TWAIN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-4011
Country : US
Telephone Number : 702-431-4345
Fax Number : 702-431-4406
Authorized Official
Title or Position : FACILITY EXECUTIVE DIRECTOR
Name : KRISTIN BERG
Credential :
Telephone Number : 702-789-6233
Provider Enumeration Date : 12/20/2012
Last Update Date : 06/10/2024

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Directions to “CONCORDE TREATMENT CENTER, LLC ” Practice Location

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