MEDICARE: LAS VEGAS RESCUE MISSION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse
4	1041C0700X	Clinical Social Worker
5	175T00000X	Peer Specialist
6	101YP1600X	Pastoral Counselor
7	405300000X	Prevention Professional
8	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1811475056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS VEGAS RESCUE MISSION

Provider Business Mailing Address
First Line	:	480 W BONANZA RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3227
Country	:	US
Telephone Number	:	702-382-1766
Fax Number	:

Provider Business Practice Location Address
First Line	:	480 W BONANZA RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3227
Country	:	US
Telephone Number	:	702-932-8177
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MRS. ALYSON MARTINEZ
Credential	:	LCSW
Telephone Number	:	702-846-7941

Provider Enumeration Date	:	07/31/2018
Last Update Date	:	02/09/2026

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Directions to “LAS VEGAS RESCUE MISSION ” Practice Location

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