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General NPI Number Information
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NPI Number | 1235070137
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Entity Type | Organization
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Legal Business Name | INNOVATIVE MANAGED BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 395 MOUNT MAHOGANY COURT
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City | RENO
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State | NV
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Zip | 89511
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Country | US
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Telephone | 775-772-7017
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Fax |
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Provider Business Mailing Address
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Address Line | 18124 WEDGE PKWY STE 245
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City | RENO
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State | NV
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Zip | 89511-8134
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Country | US
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Telephone | 775-772-7017
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GARYN RAMOS
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Credential |
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Telephone | 775-772-7107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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