ADVANCE ADDICTION TREATMENT CENTER (NPI# 1053879247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053879247 |
| Entity Type | Organization |
| Organization Name | ADVANCE ADDICTION TREATMENT CENTER |
| Other Organization Name | AA TREATMENT CENTER |
| Practice Address |
3130 S Rainbow Blvd Ste 304 Las Vegas NV 89146-6212 |
| Mailing Address |
7040 Laredo St Ste E Las Vegas NV 89117-3044 |
| Practice Telephone | 7027762482 |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | EDWARD GAMBOA (CEO) |
| Authorized Official Telephone | 7027762482 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310500000X | Intermediate Care Facility, Mental Illness | Nursing & Custodial Care Facilities | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| N | 261QR0800X |
Clinic/Center Specialization: Recovery Care |
Ambulatory Health Care Facilities | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 225C00000X | Rehabilitation Counselor | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| AA Treatment Center | Doing Business As Name - Organization |
| Street Address |
3130 S RAINBOW BLVD STE 304 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89146-6212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770714966 | Kathleen Arch | Social Worker | 3130 S Rainbow Blvd Ste 304, Las Vegas, NV 89146-6212 | 2009-08-05 |
| 1881242949 | Joy Behavioral Health LLC | Counselor | 3130 S Rainbow Blvd Ste 304, Las Vegas, NV 89146-6212 | 2019-08-30 |
| 1114587813 | Joy Behavioral Health, LLC | Clinic/Center | 3130 S Rainbow Blvd Ste 304, Las Vegas, NV 89146-6212 | 2019-06-17 |
| 1891266037 | Maria Del Carmen Leyva Vicente | Home Health Aide | 3130 S Rainbow Blvd Ste 304, Las Vegas, NV 89146-6212 | 2018-12-16 |
| 1598233546 | Carolina Cajica | Rehabilitation Practitioner | 3130 S Rainbow Blvd Ste 304, Las Vegas, NV 89146-6212 | 2018-11-07 |
| 1386156974 | Keren Yadai Sclafani | Counselor | 3130 S Rainbow Blvd Ste 304, Las Vegas, NV 89146-6212 | 2017-11-03 |
| 1144745522 | Kimberly Dawn Gollen | Behavior Technician | 3130 S Rainbow Blvd Ste 304, Las Vegas, NV 89146-6212 | 2017-08-07 |
| 1023548427 | Natalie Garcia | Behavior Technician | 3130 S Rainbow Blvd Ste 304, Las Vegas, NV 89146-6212 | 2017-06-18 |
| 1124556543 | Johanna Favela Chaidez | Behavioral Analyst | 3130 S Rainbow Blvd Ste 304, Las Vegas, NV 89146-6212 | 2017-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821607193 | State of Nevada | Community/Behavioral Health | 6171 W Charleston Blvd Bldg 15, Las Vegas, NV 89146 | 2020-07-23 |
| 1730726597 | Jenna Leigh White | Occupational Therapist | 2012 S Jones Blvd., Las Vegas, NV 89146 | 2019-11-28 |
| 1649828898 | Rocio Ferat | Chore Provider | 5000 W. Oakey Suite E.i, Las Vegas, NV 89146 | 2019-08-30 |
| 1912554007 | Juan Zamora | Chore Provider | 5000 W. Oakey Bld Suite E-1, Las Vegas, NV 89146 | 2019-08-22 |
| 1407402530 | Elia Rocio Vargas-sifuentes | Chore Provider | 5000 W Oakey, Suite E.i, Las Vegas, NV 89146 | 2019-08-14 |
| 1740834050 | Zi Wang | Physician Assistant | 5300 Spring Mountain Rd Ste 112, Las Vegas, NV 89146 | 2019-07-25 |
| 1871145565 | Virginia Lopez Lopez | Chore Provider | 5000 W. Oakey Blvd. Suite E-1, Las Vegas, NV 89146 | 2019-07-12 |
| 1962054726 | Nona Sixta Q Baldonado | Technician | 5450 W Sahara Ave Ste 250a, Las Vegas, NV 89146 | 2019-07-11 |
| 1326600701 | Thelma Moreno Cerros | Chore Provider | 5000 W. Oakey Blvd Suite E-1, Las Vegas, NV 89146 | 2019-07-05 |
| 1992367866 | Carolina Perez | Chore Provider | 5000 W Oakey Blvd Suite E-1, Las Vegas, NV 89146 | 2019-07-01 |
| Find all providers in zip 89146 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200723 | Bauza Neuropsychiatry Center LLC | Counselor | 4268 Roanridge Ave, Las Vegas, NV 89120-2113 | 2020-09-16 |
| 1306451711 | Crest Healthcare Inc. | Counselor | 3275 S Jones Blvd Ste 106, Las Vegas, NV 89146-6768 | 2020-09-11 |
| 1043821671 | New Directions LLC | Counselor | 3651 S Lindell Dr, Ste D15 B, Las Vegas, NV 89103 | 2020-08-17 |
| 1831707975 | Jennifer Fluharty | Counselor | 8934 Candice Creek Ct, Las Vegas, NV 89149-3263 | 2020-07-15 |
| 1225666597 | Gwendolyn Mallory | Counselor | 4550 W Sahara Ave Apt 1241, Las Vegas, NV 89102-3648 | 2020-03-31 |
| 1134754120 | Shelley Denise Sargent | Counselor | 10593 Harvest Green Way, Las Vegas, NV 89135-1245 | 2020-03-10 |
| 1720610637 | Dsa Technoligies LLC | Counselor | 9504 City Hill Ct, Las Vegas, NV 89134-1711 | 2020-02-08 |
| 1811532781 | Melanie Fedraw | Counselor | 3661 S Maryland Pkwy Ste 64, Las Vegas, NV 89169-3005 | 2019-11-14 |
| 1457906729 | Elizabeth Ann Morris | Counselor | 7408 Mountain Thicket St, Las Vegas, NV 89131-4542 | 2019-08-05 |
| 1902450455 | Tracey Anora Henry | Counselor | 3675 Pecos Mecleod Ste 900, Las Vegas, NV 89121 | 2019-08-01 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.