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General NPI Number Information
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NPI Number | 1396467999
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE SERVICES LLC
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 75 PRINGLE WAY STE 801B
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City | RENO
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State | NV
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Zip | 89502-8400
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Country | US
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Telephone | 775-982-5000
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Fax | 775-982-3900
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Provider Business Mailing Address
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Address Line | 1155 MILL ST # M14
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City | RENO
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State | NV
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Zip | 89502-1576
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Country | US
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Telephone | 775-982-5262
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Fax | 775-982-5496
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Authorized Official
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Title or Position | CFO MEDICAL GROUP
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Name | REBEKAH WINTER
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Credential |
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Telephone | 775-982-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number |
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License Number State |
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