MEDICARE: SILVER STATE REHAB & WELLNESS CENTER LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	251S00000X	Community/Behavioral Health Agency
3	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)
4	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1942051958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER STATE REHAB & WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	5229 MISTY MORNING DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-0601
Country	:	US
Telephone Number	:	702-550-2215
Fax Number	:

Provider Business Practice Location Address
First Line	:	5229 MISTY MORNING DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-0601
Country	:	US
Telephone Number	:	702-550-2215
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ARMINE MATINYAN
Credential	:
Telephone Number	:	702-550-2215

Provider Enumeration Date	:	03/28/2024
Last Update Date	:	03/28/2024

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