Organization
STATE OF NEVADA
Active
Organization
STATE OF NEVADA
Active
Parent organization
STATE OF NEVADA
Other names
Northern Nevada Adult Mental Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEVADA
Authorized official
ELIZABETH O'BRIEN (BUSINESS MANAGER)
(775) 688-2030
Entity
Organization
Contact information
Practice address
480 GALLETTI WAY, SPARKS, NV 89431-5564
(775) 688-2001
Mailing address
480 GALLETTI WAY, SPARKS, NV 89431-5564
(775) 688-2001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001316868
—
NV
Enumeration date
10/20/2009
Last updated
10/20/2009
Update your record
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