Healthcare Provider Details

I. General information

NPI: 1437363348
Provider Name (Legal Business Name): BREA RENO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 PLUMAS ST
RENO NV
89509-4515
US

IV. Provider business mailing address

3105 PLUMAS ST
RENO NV
89509-4515
US

V. Phone/Fax

Practice location:
  • Phone: 775-828-5000
  • Fax: 775-828-5001
Mailing address:
  • Phone: 775-828-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number1884AGZ-15
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ANNA F.C. MUNOZ
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 414-918-5443