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NPI Code Detail

MEDICARE: MISSION TREATMENT CENTERS, INC.

MEDICARE: MISSION TREATMENT CENTERS, INC.
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
2324500000XSubstance Abuse Rehabilitation Facility
3251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326354697
Entity Type Code : Organization
Provider Name (Legal Business Name) : MISSION TREATMENT CENTERS, INC.
Provider Business Mailing Address
First Line : PO BOX 682669
Second Line :
City : FRANKLIN
State : TN
Zip : 37068-2669
Country : US
Telephone Number : 760-710-0819
Fax Number :
Provider Business Practice Location Address
First Line : 2887 S MARYLAND PARKWAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-1511
Country : US
Telephone Number : 702-474-4104
Fax Number : 702-474-4108
Authorized Official
Title or Position : VP & SECRETARY
Name : BRIAN FARLEY
Credential :
Telephone Number : 615-861-6000
Provider Enumeration Date : 08/25/2010
Last Update Date : 01/12/2026

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Practice Location Address:
2887 S MARYLAND PARKWAY
LAS VEGAS, NV
89109-1511
Practice Phone: 702-474-4104
Practice Fax: 702-474-4108
1962829945 — MISSION TREATMENT CENTERS
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LAS VEGAS, NV
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1548662489 — SARAI VASQUEZ LPN
Practice Location Address:
2887 S MARYLAND PKWY
LAS VEGAS, NV
89109-1511
Practice Phone: 702-474-4104
Practice Fax: 702-474-4108
1851794622 — MR. PATRICK JAMES MCCULLAGH
Practice Location Address:
2887 S MARYLAND PKWY
LAS VEGAS, NV
89109-1511
Practice Phone: 702-474-4104
Practice Fax:
1598129363 — ESSIE WEBB
Practice Location Address:
2887 S MARYLAND PKWY
LAS VEGAS, NV
89109-1511
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Practice Fax:
1457833980 — NATALIE JOHNSON
Practice Location Address:
2887 S MARYLAND PKWY
LAS VEGAS, NV
89109-1511
Practice Phone: 702-474-4104
Practice Fax: 702-474-4108

Directions to “MISSION TREATMENT CENTERS, INC. ” Practice Location

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