Provider Demographics
NPI:1568896736
Name:DONALD POSSON, PH.D., LADC
Entity Type:Organization
Organization Name:DONALD POSSON, PH.D., LADC
Other - Org Name:RETREAT, RESPITE, RE-CREATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:POSSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LADC
Authorized Official - Phone:702-684-1455
Mailing Address - Street 1:8275 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2591
Mailing Address - Country:US
Mailing Address - Phone:702-684-1455
Mailing Address - Fax:
Practice Address - Street 1:5655 INDIAN SPRINGS ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-5079
Practice Address - Country:US
Practice Address - Phone:702-684-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-24
Last Update Date:2013-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1082261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder