Provider Demographics
NPI:1649402520
Name:CENTER FOR ADDICTION MEDICINE LLC
Entity Type:Organization
Organization Name:CENTER FOR ADDICTION MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-873-7800
Mailing Address - Street 1:4445 S JONES BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3373
Mailing Address - Country:US
Mailing Address - Phone:702-873-7800
Mailing Address - Fax:702-873-0834
Practice Address - Street 1:4445 S JONES BLVD STE 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3373
Practice Address - Country:US
Practice Address - Phone:702-873-7800
Practice Address - Fax:702-873-0834
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHAEL S. LEVY D.O., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-11
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder