NPIMap

Organization Active NPI

State of Nevada

  • Psychiatric Residential Treatment Facility
  • Sparks, NV
National Provider Identifier
1659448017
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
STATE OF NEVADA
Practice address
480 Galletti Way
Sparks, NV 89431-5564
Phone
(775) 688-1633
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Marty Carraher
Title
Administrative Services Officer
Phone
(775) 688-1658

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

480 Galletti Way
Sparks, NV 89431-5564

Mailing address

2655 Enterprise Rd
Reno, NV 89512-1666
Phone (775) 688-1600

Other identifiers 1

IdentifierTypeStateIssuer
100507984MedicaidNV

Other names 1

  • State of Nevada, DHHS, Division of Child and Family Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nevada State Health Division125 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1659448017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 ENTERPRISE RD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895121666",
            "telephone_number": "775-688-1600",
            "fax_number": "775-688-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 GALLETTI WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315564",
            "telephone_number": "775-688-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "CARRAHER",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES OFFICER",
        "authorized_official_telephone_number": "775-688-1658",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507984",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "State of Nevada, DHHS, Division of Child and Family Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.