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Organization
TAHOE YOUTH & FAMILY SERVICES
Active
Organization
TAHOE YOUTH & FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER CROFT (EXECUTIVE DIRECTOR)
(775) 782-4202
Entity
Organization
Contact information
Practice address
100 FOOTHILL RD., BUILDING D, ROOM 5, MARKLEEVILLE, CA 96120-9631
(775) 782-4202
Mailing address
1512 US HIGHWAY 395 N, SUITE 3, GARDNERVILLE, NV 89410-5282
(775) 782-4202
(775) 782-5055
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C0636452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265625636
MEDI-CAL
CA
05
—
1700173077
—
NV
Enumeration date
05/07/2014
Last updated
04/14/2015
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