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General NPI Number Information
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NPI Number | 1841984424
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Entity Type | Organization
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Legal Business Name | MT ROSE HEALTH FOUNDATION
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 211 JOHN EUGENE CT
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City | RENO
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State | NV
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Zip | 89503-1040
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Country | US
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Telephone | 775-391-6078
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Fax |
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Provider Business Mailing Address
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Address Line | 211 JOHN EUGENE CT
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City | RENO
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State | NV
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Zip | 89503-1040
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Country | US
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Telephone | 775-391-6078
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CRYSTAL NEJABAT
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Credential | MA, CPC
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Telephone | 775-843-7517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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