Provider Demographics
NPI:1174064786
Name:DR. MIRIAM & SHELDON G ADELSON CLINIC FOR DRUG ABUSE TREATMENT & RESEA
Entity type:Organization
Organization Name:DR. MIRIAM & SHELDON G ADELSON CLINIC FOR DRUG ABUSE TREATMENT & RESEA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DINITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-735-7900
Mailing Address - Street 1:3661 S MARYLAND PKWY
Mailing Address - Street 2:STE 64
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-3003
Mailing Address - Country:US
Mailing Address - Phone:702-735-7900
Mailing Address - Fax:702-735-0081
Practice Address - Street 1:3661 S MARYLAND PKWY
Practice Address - Street 2:STE 64
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3003
Practice Address - Country:US
Practice Address - Phone:702-735-7900
Practice Address - Fax:702-735-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM2800X
NV2583NTC-15101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadoneGroup - Single Specialty