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General NPI Number Information
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NPI Number | 1952716474
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Entity Type | Organization
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Legal Business Name | SIERRA NEVADA BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 6751 MAGICAL DR
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City | SPARKS
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State | NV
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Zip | 89436-7173
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Country | US
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Telephone | 760-832-2056
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Fax |
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Provider Business Mailing Address
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Address Line | 6751 MAGICAL DR
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City | SPARKS
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State | NV
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Zip | 89436-7173
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Country | US
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Telephone | 760-832-2056
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Fax |
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Authorized Official
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Title or Position | CHEIF OPERATING OFFICER
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Name | MICHAEL CHRISTOPHER HARRIS
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Credential |
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Telephone | 760-832-2056
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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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