Organization Name: | STATE OF NEVADA |
NPI Number: | 1992887822 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RAY C KENDALL (AGENCY DIRECTOR) |
Mailing Address: | 175 W Us Highway 50 Stateline |
State: | NV US |
Postal Code: | 89779 |
Phone Number: | 7756873671 |
Fax Number: | 7756876639 |
NPI Enumeration Date: | 10/19/2006 |
NPI Last Update Date: | 10/10/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |