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General NPI Number Information
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NPI Number | 1710948070
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Entity Type | Organization
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Legal Business Name | SAINT MARY'S MULTI-SPECIALTY CLINIC, INC.
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 1510 MEADOW WOOD LN
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City | RENO
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State | NV
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Zip | 89502-8503
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Country | US
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Telephone | 775-770-7210
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Fax | 775-770-7211
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Provider Business Mailing Address
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Address Line | 645 N ARLINGTON AVE STE 555
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City | RENO
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State | NV
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Zip | 89503-4452
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Country | US
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Telephone | 775-770-7661
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Fax | 775-770-7368
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | DAVE CHALLIS
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Credential |
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Telephone | 775-770-6679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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