MEDICARE: TRAUMA TREATMENT SOLUTIONS CLINIC LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	106H00000X	Marriage & Family Therapist
2	2084P0800X	Psychiatry Physician
3	251S00000X	Community/Behavioral Health Agency
4	363L00000X	Nurse Practitioner
5	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1316772882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAUMA TREATMENT SOLUTIONS CLINIC LLC

Provider Business Mailing Address
First Line	:	8509 BROWNSTONE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-7866
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8509 BROWNSTONE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-7866
Country	:	US
Telephone Number	:	815-919-2362
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BYRON WILLIAMS
Credential	:
Telephone Number	:	815-919-2362

Provider Enumeration Date	:	09/04/2024
Last Update Date	:	01/28/2025

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