Organization
GOING PLACES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BART ALBERT VANDAMME QIDP (DIRECTOR)
(775) 342-7323
Entity
Organization
Contact information
Practice address
5365 MAE ANNE AVE STE A10, RENO, NV 89523-1841
(775) 342-7323
(775) 323-6263
Mailing address
5365 MAE ANNE AVE STE A10, RENO, NV 89523-1841
(775) 342-7323
(775) 323-6263
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699135335
—
NV
Enumeration date
08/05/2016
Last updated
08/05/2016
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