Healthcare Provider Details

I. General information

NPI: 1629191085
Provider Name (Legal Business Name): VETERANS ADMINISTRATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 LOCUST ST
RENO NV
89502-2597
US

IV. Provider business mailing address

555 KEATS CIR
RENO NV
89506-1922
US

V. Phone/Fax

Practice location:
  • Phone: 775-328-1792
  • Fax:
Mailing address:
  • Phone: 775-972-0518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberRN48983
License Number StateNV

VIII. Authorized Official

Name: BRIAN HANDFINGER
Title or Position: REGISTERED NURSE
Credential:
Phone: 775-972-0518