| Organization Name: | NV ST DV MH/DS NO NV MR SVCE |
| NPI Number: | 1144681099 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLEY STEPRO (ACCOUNTING ASSISTANT IV) |
| Mailing Address: | 605 S 21st St Sparks |
| State: | NV US |
| Postal Code: | 894318100 |
| Phone Number: | 7756881930 |
| Fax Number: | |
| NPI Enumeration Date: | 03/18/2016 |
| NPI Last Update Date: | 03/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | PY0389 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |