Individual
JAMES ERICH BAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
HC 34 BOX 34165, ELY, NV 89301-9206
(775) 238-5100
(775) 238-5103
Mailing address
HC 34 BOX 34165, ELY, NV 89301-9206
(775) 238-5100
(775) 238-5103
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
1389-13
NV
Other
Enumeration date
05/23/2013
Last updated
05/23/2013
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