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General NPI Number Information
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NPI Number | 1174960322
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Entity Type | Individual
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Provider Name | CHRISTOPHER GENTINE C.A.D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/29/2013
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 50 RIVER ST # 4
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City | DAYTON
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State | NV
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Zip | 89403-6721
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Country | US
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Telephone | 775-246-6214
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Fax | 775-246-6314
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Provider Business Mailing Address
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Address Line | 50 RIVER ST # 4
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City | DAYTON
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State | NV
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Zip | 89403-6721
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 00217-C
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License Number State | NV
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