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Organization
ADVANCE ADDICTION TREATMENT CENTER
Active
Organization
ADVANCE ADDICTION TREATMENT CENTER
Active
Other names
AA Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD GAMBOA (CEO)
(702) 776-2482
Entity
Organization
Contact information
Practice address
3130 S RAINBOW BLVD STE 304, LAS VEGAS, NV 89146-6212
(702) 776-2482
Mailing address
7040 LAREDO ST STE E, LAS VEGAS, NV 89117-3044
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
225C00000X
Rehabilitation Counselor
—
NULL
225C00000X
Rehabilitation Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
261QR0800X
Recovery Care Clinic/Center
—
NULL
310500000X
Mental Illness Intermediate Care Facility
—
NULL
Other
Enumeration date
03/06/2019
Last updated
03/28/2019
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