| State Of Nevada | |
|
925 Wells Ave Wendover NV 89883 | |
| (775) 664-2220 | |
| (775) 664-2965 |
| Full Name | State Of Nevada |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 925 Wells Ave, Wendover, Nevada |
| Authorized Official Name and Position | Ray C Kendall (AGENCY DIRECTOR) |
| Authorized Official Contact | 77566877500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Nevada 4126 Technology Way Suite 102 Carson City NV 89706-2013 Ph: (775) 687-7505 | State Of Nevada 925 Wells Ave Wendover NV 89883 Ph: (775) 664-2220 |
| NPI Number | 1891877734 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 10/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891877734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |