Individual
JASON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2470 WRONDEL WAY STE 275, RENO, NV 89502-3701
(775) 354-3991
(775) 336-1082
Mailing address
2470 WRONDEL WAY STE 275, RENO, NV 89502-3701
(775) 354-3991
(775) 336-1082
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
4200227759
NV
Other
Enumeration date
06/18/2014
Last updated
06/19/2014
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