Provider Demographics
NPI:1114365731
Name:DR. MIRIAM & SHELDON ADELSON CLINIC FOR DRUG ABUSE TREATMENT & RESEARC
Entity Type:Organization
Organization Name:DR. MIRIAM & SHELDON ADELSON CLINIC FOR DRUG ABUSE TREATMENT & RESEARC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LINZY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:702-735-7900
Mailing Address - Street 1:3661 S MARYLAND PKWY
Mailing Address - Street 2:SUITE 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:SUITE 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:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV01702160Medicaid