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General NPI Number Information
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NPI Number | 1114430311
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Entity Type | Organization
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Legal Business Name | PRIME HEALTHCARE SERVICES RENO LLC
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 235 W 6TH ST
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City | RENO
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State | NV
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Zip | 89503-4548
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Country | US
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Telephone | 775-770-3000
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Fax | 755-770-3963
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Provider Business Mailing Address
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Address Line | 235 W 6TH ST
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City | RENO
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State | NV
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Zip | 89503-4548
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Country | US
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Telephone | 775-770-3000
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Fax | 755-770-3963
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Authorized Official
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Title or Position | CHIEF COMPLIANCE COUNSEL
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Name | CHRISTOPHER DOAN
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Credential |
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Telephone | 909-235-4307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 658-HOS-31
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License Number State | NV
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