Organization
STATE OF NEVADA
Active
Other names
DOUGLAS MENTAL HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
SIRI MCMILLIN (BILLING SUPERVISOR)
(775) 684-5018
Entity
Organization
Contact information
Practice address
1528 US HIGHWAY 395 N, SUITE 100, GARDNERVILLE, NV 89410-5265
(775) 782-3671
(775) 782-6639
Mailing address
727 FAIRVIEW DR, SUITE A, CARSON CITY, NV 89701-5795
(775) 687-5018
(775) 687-1181
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005403001
—
NV
Enumeration date
02/06/2008
Last updated
10/20/2015
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