Provider Demographics
NPI:1063617736
Name:VEGAS VALLEY TREATMENT CENTER
Entity type:Organization
Organization Name:VEGAS VALLEY TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:ZEITLIN
Authorized Official - Suffix:
Authorized Official - Credentials:702-383-9890
Authorized Official - Phone:702-383-9890
Mailing Address - Street 1:1325 S COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2530
Mailing Address - Country:US
Mailing Address - Phone:702-383-9890
Mailing Address - Fax:
Practice Address - Street 1:1325 S COMMERCE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2530
Practice Address - Country:US
Practice Address - Phone:702-383-9890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4530NTC-0261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone