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General NPI Number Information
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NPI Number | 1285833640
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Entity Type | Organization
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Legal Business Name | NO. NV ADLT MNTL HLTH SVCS
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 480 GALLETTI WAY
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City | SPARKS
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State | NV
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Zip | 89431-5564
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Country | US
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Telephone | 775-688-2001
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Fax | 775-688-2192
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Provider Business Mailing Address
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Address Line | 480 GALLETTI WAY
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City | SPARKS
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State | NV
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Zip | 89431-5564
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Country | US
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Telephone | 775-688-2001
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Fax | 775-688-2192
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | ELIZABETH A O'BRIEN
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Credential |
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Telephone | 775-688-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | IA00246
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License Number State | NV
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