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
—
—
104100000X
Social Worker
—
—
225C00000X
Rehabilitation Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
Other
Enumeration date
03/06/2019
Last updated
03/28/2019
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