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General NPI Number Information
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NPI Number | 1609361088
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Entity Type | Organization
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Legal Business Name | DOUGLAS COUNTY AND UNINCORPORATED TOWNS
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | CHINA SPRING YOUTH CAMP ADAPT 225 CHINA SPRING ROAD
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City | GARDNERVILLE
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State | NV
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Zip | 89410
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Country | US
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Telephone | 775-265-5635
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 218
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City | MINDEN
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State | NV
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Zip | 89423-0218
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Country | US
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Telephone | 775-265-5350
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. WENDY COLLEEN GARRISON
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Credential |
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Telephone | 775-265-5350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | NV
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