Healthcare Provider Details

I. General information

NPI: 1982239000
Provider Name (Legal Business Name): RONALD MCDONALD HOUSE CHARITIES NORTHERN NEVADA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 MAINE ST
RENO NV
89502-1462
US

IV. Provider business mailing address

323 MAINE ST
RENO NV
89502-1462
US

V. Phone/Fax

Practice location:
  • Phone: 775-322-4663
  • Fax:
Mailing address:
  • Phone: 775-322-4663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: THERESA NISHIO
Title or Position: BOOKKEEPER
Credential:
Phone: 775-322-4663