Organization
DHHS, IHS, PHOENIX AREA, NEVADA SKIES YOUTH
Active
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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