Healthcare Provider Details

I. General information

NPI: 1053272989
Provider Name (Legal Business Name): COMMUNITY CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 MILL ST # M-14
RENO NV
89502-1576
US

IV. Provider business mailing address

1155 MILL ST
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-5000
  • Fax: 775-982-3900
Mailing address:
  • Phone: 775-982-5000
  • Fax: 775-982-3900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BRETT MOORE
Title or Position: CFO ACUTE CARE
Credential:
Phone: 775-982-6343