Organization
STATE OF NEVADA
Active
Organization
STATE OF NEVADA
Active
Parent organization
STATE OF NEVADA
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEVADA
Authorized official
MANDI DAVIS (DEPUTY ADMINISTRATOR)
(775) 684-7942
Entity
Organization
Contact information
Practice address
4600 KIETZKE LANE BLDG D, RENO, NV 89502
(775) 688-1481
(775) 688-1230
Mailing address
2655 ENTERPRISE DR., RENO, NV 89512-1666
(775) 688-1600
(775) 688-1616
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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