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General NPI Number Information
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NPI Number | 1235630864
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Entity Type | Organization
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Legal Business Name | HIGH SIERRA PSYCHIATRY, LLC
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | RENO BEHAVIORAL HEALTHCARE HOSPITAL 6940 SIERRA CENTER PARKWAY
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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 | 775-571-4766
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Fax |
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Provider Business Mailing Address
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Address Line | 1895 CARLENTINI CT
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City | RENO
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State | NV
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Zip | 89519-8336
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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 | PRESIDENT
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Name | DR. JEREMY MATUSZAK
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Credential | MD
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Telephone | 775-225-3304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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