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General NPI Number Information
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NPI Number | 1730604638
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Entity Type | Organization
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Legal Business Name | RON WOOD FAMILY RESOURCE CENTER
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2621 NORTHGATE LN STE 62
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City | CARSON CITY
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State | NV
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Zip | 89706-1619
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Country | US
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Telephone | 775-884-2269
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Fax | 775-884-2730
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Provider Business Mailing Address
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Address Line | 2621 NORTHGATE LN STE 62
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City | CARSON CITY
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State | NV
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Zip | 89706-1619
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Country | US
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Telephone | 775-884-2269
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Fax | 775-884-2730
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOYCE ANN BUCKINGHAM
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Credential |
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Telephone | 775-884-2269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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