Organization
DHHS, IHS, PHOENIX AREA, NEVADA SKIES YOUTH
Active
Other names
Nevada Skies Youth Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY M ELLIOTT RN, MS (CHIEF EXECUTIVE OFFICER)
(520) 562-4205
Entity
Organization
Contact information
Practice address
104 BIG BEND RANCH ROAD, WADSWORTH, NV 89442
(775) 352-6840
(775) 575-3180
Mailing address
PO BOX 280, 104 BIG BEND RANCH ROAD, WADSWORTH, NV 89442
(775) 352-6840
(775) 575-3180
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
N/A
NV
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
275789
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
N/A
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
727370
—
AZ
Enumeration date
05/29/2009
Last updated
10/31/2012
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