Individual
KAREN DIANE ECCLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
GF-467290
NV
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
GF-467290
NV
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
GF-467290
NV
323P00000X
Psychiatric Residential Treatment Facility
GF-467290
NV
324500000X
Substance Abuse Rehabilitation Facility
GF-467290
NV
385H00000X
Respite Care
GF-467290
NV
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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