Organization
STATE OF NV AGING & DISABILITY SEVICES DIVISION- FE WAIVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANIL MANOCHA (ADMINISTRATIVE SERVICES OFFICER)
(775) 687-2487
Entity
Organization
Contact information
Practice address
3416 GONI RD BLDG D, CARSON CITY, NV 89706-8008
(775) 687-2487
Mailing address
3416 GONI RD BLDG D, CARSON CITY, NV 89706-8008
(775) 687-2487
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
12/30/2019
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