Organization
NEVADA STATE TRIAGE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLIFFORD ETIENNE B.S. (CHIEF FINANCIAL OFFIER)
(702) 771-0304
Entity
Organization
Contact information
Practice address
5530 S JONES BLVD, LAS VEGAS, NV 89118-0566
(702) 683-4498
Mailing address
5530 S JONES BLVD, LAS VEGAS, NV 89118-0566
(702) 909-3440
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
09/04/2018
Last updated
01/15/2019
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