Healthcare Provider Details

I. General information

NPI: 1821916461
Provider Name (Legal Business Name): NORTHERN NEVADA HIV OUTPATIENT PROGRAM EDUCATION AND SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 E 4TH ST
RENO NV
89512-3789
US

IV. Provider business mailing address

580 W 5TH ST
RENO NV
89503-4419
US

V. Phone/Fax

Practice location:
  • Phone: 775-786-4673
  • Fax:
Mailing address:
  • Phone: 775-786-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KYLE SUNDLAND
Title or Position: VP OF BEHAVIORAL HEALTH
Credential: LCSW
Phone: 775-786-4673