Nevada Treatment Center Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

APRN000902 Issued in NV

Legal business name

NEVADA TREATMENT CENTER INC.

Practice address

1721 East Charleston Blvd
1721
Las Vegas, NV 89104

Phone

(702) 515-9680

NPI assigned

Sep 21, 2016

Organization subpart

Yes

Parent organization

NEVADA CARE CENTER INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Festus Ebonka, NP

Title

President

Phone

(702) 515-9680

Specialties & licenses 1

Addresses

Part of

Nevada Treatment Center Inc

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1740738533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 E CHARLESTON BLVD",
            "address_2": "1721",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041902",
            "telephone_number": "702-515-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 EAST CHARLESTON BLVD",
            "address_2": "1721",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89104",
            "telephone_number": "702-515-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA TREATMENT CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEVADA CARE CENTER INC",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "EBONKA",
        "authorized_official_first_name": "FESTUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-515-9680",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NV",
            "license": "APRN000902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nevada Telerad LLC
• Nevada Therapy Collective LLC
• Nevada TMJ Institute
• Nevada TMS LLC
• Nevada Treatment Center
• Nevada Treatment Center LLC
• Nevada Valley Home Care
• Nevada Vitalcare Inc.
• Nevada We Care
• Nevada Wholeness Therapeutics

• Primary Care Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Primary Care Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.