| State Of Nevada | |
|
775 Cornell Ave Ste A-1 Lovelock NV 89419-8047 | |
| (775) 273-1036 | |
| (775) 273-1109 |
| Full Name | State Of Nevada |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 775 Cornell Ave Ste A-1, Lovelock, Nevada |
| Authorized Official Name and Position | Ellen Richardson-adams (AGENCY MANAGER) |
| Authorized Official Contact | 7024864400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Nevada Attn: Cyndi Smith 240 S. Humahuaca Pahrump NV 89048-2199 Ph: (775) 751-7406 | State Of Nevada 775 Cornell Ave Ste A-1 Lovelock NV 89419-8047 Ph: (775) 273-1036 |
| NPI Number | 1831271766 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 11/10/2022 |
| Certification Date | 11/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831271766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |