Healthcare Provider Details

I. General information

NPI: 1225721822
Provider Name (Legal Business Name): CATHOLIC CHARITIES OF NORTHERN NEVADA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E 4TH ST
RENO NV
89512-3316
US

IV. Provider business mailing address

500 E 4TH ST
RENO NV
89512-3316
US

V. Phone/Fax

Practice location:
  • Phone: 775-386-7049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARIE BAXTER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 775-842-7999