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2655 Enterprise Rd Reno NV 89512-1666 | |
(775) 688-1600 | |
(702) 688-1616 |
Full Name | |
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Speciality | Clinic/center |
Location | 2655 Enterprise Rd, Reno, Nevada |
Authorized Official Name and Position | Sandra Stone (MANAGEMENT ANALYST 3) |
Authorized Official Contact | 7024868226 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1350 S Jones Blvd Ste 220 Las Vegas NV 89146-1233 Ph: (702) 486-8226 | 2655 Enterprise Rd Reno NV 89512-1666 Ph: (775) 688-1600 |
NPI Number | 1649400417 |
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Provider Enumeration Date | 07/15/2009 |
Last Update Date | 09/20/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649400417 | NPI | - | NPPES |
100507998 | Medicaid | NV | |
100522831 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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