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NPI 1902166903

NPI 1902166903 : EXPRESSIONS BEHAVIORAL HEALTH SERVICES, INC. : RENO, NV

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General NPI Number Information
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    NPI Number           |    1902166903
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    Entity Type          |    Organization 
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    Legal Business Name  |    EXPRESSIONS BEHAVIORAL HEALTH SERVICES, INC. 
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Dates
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    Enumeration Date     |    05/23/2012
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    Last Update Date     |    05/23/2012
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Provider Practice Location Address
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    Address Line         |    3680 GRANT DR STE L 
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    City                 |    RENO
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    State                |    NV
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    Zip                  |    89509-5350
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    Country              |    US
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    Telephone            |    775-825-9090
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3680 GRANT DR STE L 
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    City                 |    RENO
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    State                |    NV
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    Zip                  |    89509-5350
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ALI JAI  FAISON 
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    Credential           |    
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    Telephone            |    775-825-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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