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NPI Code Detail

MEDICARE: MISSION TREATMENT CENTERS

MEDICARE: MISSION TREATMENT CENTERS
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
1251S00000XCommunity/Behavioral Health AgencyNV20071612296NV

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 : 1962829945
Entity Type Code : Organization
Provider Name (Legal Business Name) : MISSION TREATMENT CENTERS
Provider Business Mailing Address
First Line : 7371 PRAIRIE FALCON RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0834
Country : US
Telephone Number : 619-818-8106
Fax Number :
Provider Business Practice Location Address
First Line : 2887 S MARYLAND PKWY
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 : OWNER/PRESIDENT
Name : MARC LEWISON
Credential :
Telephone Number : 619-818-8106
Provider Enumeration Date : 03/27/2014
Last Update Date : 01/28/2019

Similar Medicare Providers

1912509928 — MISSION TREATMENT CENTERS, INC.
Practice Location Address:
2887 S MARYLAND PARKWAY
LAS VEGAS, NV
89109-1511
Practice Phone: 702-474-4104
Practice Fax: 702-474-4108
1326354697 — MISSION TREATMENT CENTERS, INC.
Practice Location Address:
2887 S MARYLAND PARKWAY
LAS VEGAS, NV
89109-1511
Practice Phone: 702-474-4104
Practice Fax: 702-474-4108
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
Practice Phone: 702-840-3586
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 ” Practice Location

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