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General NPI Number Information
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NPI Number | 1497780167
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Entity Type | Organization
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Legal Business Name | NEVADA FAMILY PRACTICE RESIDENCY PROGRAM, INC.
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 745 W MOANA LN SUITE 100
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City | RENO
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State | NV
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Zip | 89509-4932
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Country | US
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Telephone | 775-334-3033
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Fax | 775-334-3022
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Provider Business Mailing Address
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Address Line | 745 W MOANA LN SUITE 100
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City | RENO
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State | NV
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Zip | 89509-4932
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Country | US
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Telephone | 775-334-3033
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Fax | 775-334-3022
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES R PARCELLS
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Credential | LISW
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Telephone | 702-968-5059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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