MEDICARE: FLAGG LLC D/B/A REALITY RECOVERY

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	308L	NV

General Provider Information

NPI Number	:	1942491592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLAGG LLC D/B/A REALITY RECOVERY

Provider Business Mailing Address
First Line	:	3520 E TROPICANA AVE
Second Line	:	SUITE E
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7342
Country	:	US
Telephone Number	:	702-434-4029
Fax Number	:	702-434-4033

Provider Business Practice Location Address
First Line	:	3520 E TROPICANA AVE
Second Line	:	SUITE E
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7342
Country	:	US
Telephone Number	:	702-434-4029
Fax Number	:	702-434-4033

Authorized Official
Title or Position	:	CEO - PRESIDENT
Name	:	MR. ALLEN B FLAGG
Credential	:
Telephone Number	:	702-434-4029

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	09/17/2008

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