Provider Demographics
NPI:1083257851
Name:VEGAS STRONGER
Entity Type:Organization
Organization Name:VEGAS STRONGER
Other - Org Name:SOLUTIONS RECOVERY FOUNDATION DBA VEGAS STRONGER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MARLON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LADC
Authorized Official - Phone:702-234-1356
Mailing Address - Street 1:840 S RANCHO DR # 4323
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3837
Mailing Address - Country:US
Mailing Address - Phone:702-234-1356
Mailing Address - Fax:
Practice Address - Street 1:737 N MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-1918
Practice Address - Country:US
Practice Address - Phone:702-234-1356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No251K00000XAgenciesPublic Health or Welfare
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility