Impact Communtiy Service Llc

NPI 1184922916 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1184922916
Enumeration Date 03/02/2011
Last Updated 03/02/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name DONALD WADE DONALD
Position BASIC SKILLS TRAINER
Phone (775) 677-2640
Fax
Practice Location
9801 CRYSTALLINE DR
RENO NV, 89506-7566, US
Phone (775) 677-2640
Fax
Business Location
9801 CRYSTALLINE DR
RENO NV, 89506-7566, US
Phone (775) 677-2640
Fax
Toxanomy
Taxonomy Code 322D00000X
License State Nevada
License Number GF125403151
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According to our database, Impact Communtiy Service Llc NPI is 1184922916, taxonomy code is 322D00000X and license number is GF125403151, license state is located at Nevada. Impact Communtiy Service Llc physically located at 9801 Crystalline Dr, Reno NV, 89506-7566. NPI Number 1033115704 has the healthcare provider type.

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1184922916 NPI number is provided on an as is basis without warranty of any kind. 1184922916 is maintained by the National Plan & Provider Enumeration System. The contents of Impact Communtiy Service Llc are for informational purposes only.