Healthcare Provider Details

I. General information

NPI: 1225512452
Provider Name (Legal Business Name): ELKO COUNTY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 ELM ST
ELKO NV
89801-3349
US

IV. Provider business mailing address

850 ELM ST
ELKO NV
89801-3349
US

V. Phone/Fax

Practice location:
  • Phone: 775-738-5196
  • Fax: 775-777-1195
Mailing address:
  • Phone: 775-738-5196
  • Fax: 775-777-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. TATE WELDON ELSE
Title or Position: SPECIAL SERVICES DIRECTOR
Credential:
Phone: 775-738-5196