Organization
TRANQUILITY RECOVERY NV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW KHUDAVERDYAN (OWNER/CEO)
(702) 900-8341
Entity
Organization
Contact information
Practice address
6325 HARRISON DR STE 2, LAS VEGAS, NV 89120-4402
(702) 900-8341
(702) 549-7610
Mailing address
3870 E FLAMINGO RD # A2-525, LAS VEGAS, NV 89121-6228
(702) 706-4969
(702) 549-7610
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
—
—
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
—
—
2083T0002X
Medical Toxicology (Preventive Medicine) Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
10/30/2023
Last updated
01/19/2024
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