NEVADA STATE TRIAGE CENTER (NPI# 1790267912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790267912 |
| Entity Type | Organization |
| Organization Name | NEVADA STATE TRIAGE CENTER |
| Practice Address |
5530 S Jones Blvd Las Vegas NV 89118-0566 |
| Practice Telephone | 7026834498 |
| Mailing Telephone | 7029093440 |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2019-01-15 |
| Authorized Official Name | MR. CLIFFORD ETIENNE (CHIEF FINANCIAL OFFIER) |
| Authorized Official Telephone | 7027710304 |
| Authorized Official Credential | B.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| N | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 276400000X | Rehabilitation, Substance Use Disorder Unit | Hospital Units | ||
| N | 405300000X | Prevention Professional | Other Service Providers | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
5530 S JONES BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89118-0566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053336784 | Joan Mccraw | Nurse Practitioner | 5530 S Jones Blvd, Las Vegas, NV 89118 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720568520 | Kurt Yaross | Behavioral Analyst | 7138 W Post Rd, #208, Las Vegas, NV 89118 | 2018-08-21 |
| 1619457108 | Michelle Herzberg | Behavioral Analyst | 7318 W Post Rd #280, Las Vegas, NV 89118 | 2018-08-15 |
| 1548749385 | Keisha Bere-ruiz | Behavioral Analyst | 7318 W Post Rd #208, Las Vegas, NV 89118 | 2018-08-13 |
| 1295222081 | Aliantcare | Radiologic Technologist | 5490 S Rainbow Blvd, Suite 400 N34835, Las Vegas, NV 89118 | 2018-04-17 |
| 1710406467 | Anoush H. Tacvorian Do LLC | Clinic/Center | 6525 W. Warm Springs Rd, Suite 100, Las Vegas, NV 89118 | 2017-09-13 |
| 1962920470 | Harvard Medtech, LLC | Durable Medical Equipment & Medical Supplies | 6280 S. Valley View Blvd, Suite 412, Las Vegas, NV 89118 | 2017-09-05 |
| 1750827903 | Kerry Cutler | Nurse Practitioner | 6020 South Rainbow Blvd, Suite C, Las Vegas, NV 89118 | 2017-01-12 |
| 1184173015 | Girisgen & Kopolow Od PC | Optometrist | 7090 S Rainbow Blvd, Ste 100, Las Veegas, NV 89118 | 2016-10-04 |
| 1396117859 | Foundation for Positively Kids | Clinic/Center | 3555 E Reno, Ste F, Las Vegas, NV 89118 | 2015-10-23 |
| 1720492663 | Kiet Michael Lam | Chiropractor | 5693 S. Jones Bvld, Ste 116, Las Vegas, NV 89118 | 2014-06-18 |
| Find all providers in zip 89118 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548879638 | Luxe Treatment Center LLC | Substance Abuse Rehabilitation Facility | 4845 N Riley St, Las Vegas, NV 89149-4124 | 2020-07-24 |
| 1891312005 | Hope Street LLC | Substance Abuse Rehabilitation Facility | 4465 S Buffalo Dr Ste B, Las Vegas, NV 89147-5006 | 2020-07-03 |
| 1407483456 | There Is No Hero In Heroin (tinhih) | Substance Abuse Rehabilitation Facility | 900 Karen Ave Ste D206, Las Vegas, NV 89109-1273 | 2020-03-26 |
| 1629609441 | Ignite Teen Treatment, LLC | Substance Abuse Rehabilitation Facility | 4465 S Buffalo Dr Ste D, Las Vegas, NV 89147-5006 | 2020-01-30 |
| 1144851437 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 4011 Mcleod Dr Unit A, Las Vegas, NV 89121-4305 | 2020-01-27 |
| 1740810316 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 4011 Mcleod Dr Unit B, Las Vegas, NV 89121-4305 | 2020-01-22 |
| 1003451584 | Nevada Rehab LLC | Substance Abuse Rehabilitation Facility | 2651 Westwood Dr, Las Vegas, NV 89109-1117 | 2019-11-08 |
| 1578118717 | Vegas Wellness Treatment Center | Substance Abuse Rehabilitation Facility | 3920 W Charleston Blvd Ste N, Las Vegas, NV 89102-1651 | 2019-08-05 |
| 1629635644 | Thrive Solutions LLC | Substance Abuse Rehabilitation Facility | 5510 S Fort Apache Rd Ste 13, Las Vegas, NV 89148-7700 | 2019-05-24 |
| 1215436605 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 6655 W Sahara Ave Ste D208, Las Vegas, NV 89146-0851 | 2018-02-12 |
| 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.