MEDICARE: CENTER FOR BEHAVIORAL HEALTH LAS VEGAS, 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
1	261QM2800X	Methadone Clinic

General Provider Information

NPI Number	:	1548602022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR BEHAVIORAL HEALTH LAS VEGAS, LLC

Provider Business Mailing Address
First Line	:	5001 SPRING VALLEY RD STE 600
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-3946
Country	:	US
Telephone Number	:	214-365-6100
Fax Number	:	214-365-6150

Provider Business Practice Location Address
First Line	:	2290 MCDANIEL ST STE 1C
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6330
Country	:	US
Telephone Number	:	208-367-9021
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANTHONY KILGORE
Credential	:
Telephone Number	:	214-365-6100

Provider Enumeration Date	:	07/24/2013
Last Update Date	:	11/13/2025

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