Truckee Meadows Mental Health

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

E0146102012-5 Issued in NV

Legal business name

TRUCKEE MEADOWS MENTAL HEALTH

Practice address

4051 Kings Row
Reno, NV 89503-6825

Phone

(775) 997-5365

Fax

(775) 622-4798

NPI assigned

May 22, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Derrick C Johnson, LMFT

Title

Ceo

Phone

(775) 857-9599

Specialties & licenses 1

Addresses

Other names 1

• Alpha & Omega Residential, LLC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George Jasson Mwanjabala, C.N.A (Q.B.A)

  • Mental Health Counselor
  • Reno, NV
  • NPI 1669800561
  NPD (past)

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1740540947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9695 SILVER DESERT WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895067598",
            "telephone_number": "775-997-5365",
            "fax_number": "775-622-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 KINGS ROW",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895036825",
            "telephone_number": "775-997-5365",
            "fax_number": "775-622-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUCKEE MEADOWS MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "775-857-9599",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NV",
            "license": "E0146102012-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpha & Omega Residential, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Dylan Troxel, PHARMD
• Troy Humphreys, OD
• Debra Lynn Troyer
• Trucare Health Services, LLC
• Truckee Meadows Fire Protection District
• Truckee River Psychotherapy LLC
• True North Health, LLC
• True North Therapy LLC
• True North Treatment Center LLC
• True Pilates and Physiotherapy LLC

• Mental Illness Community Based Residential Treatment Facility in Reno, NV
• Providers in Reno, NV by specialty
• Mental Illness Community Based Residential Treatment Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.