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General NPI Number Information
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NPI Number | 1356686810
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Entity Type | Organization
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Legal Business Name | WILEY CARE HOMES, LLC
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 6679 N LATOUR
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City | SPARKS
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State | NV
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Zip | 89436-9197
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Country | US
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Telephone | 775-343-6882
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Fax | 775-384-9546
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Provider Business Mailing Address
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Address Line | 6679 N LATOUR
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City | SPARKS
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State | NV
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Zip | 89436-9197
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Country | US
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Telephone | 775-343-6882
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Fax | 775-384-9546
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. CARLNEL E WILEY JR.
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Credential |
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Telephone | 775-343-6882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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