State of Nevada
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Stateline, NV
NPI 1992887822 · NPPES record last updated Oct 10, 2007
Key facts
- NPI
- 1992887822
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- STATE OF NEVADA
- Practice address
- 175 W US Highway 50
Stateline, NV 89779 - Phone
- (775) 687-3671
- Fax
- (775) 687-6639
- NPI assigned
- Oct 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Ray C Kendall, LCSW
- Title
- Agency Director
- Phone
- (775) 687-7500
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Nevada State Health Division
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
175 W US Highway 50
Stateline, NV 89779
Mailing address
4126 Technology Way
Suite 102
Carson City, NV 89706-2013
Phone (776) 687-7573
Other names
- LAKE TAHOE MENTAL HEALTH CENTER
Other providers in Stateline, NV
- Tracy Regina Protell
- Clinton David Purvance
- Robert Edward Rupp
- Sonia N Rupp
- Martin Ernst Salm
- Steven L Kline OD a Professional Corporation
- Natalie Stevenson
- Maureen Sullivan
- Tahoe Carson Valley Medical Group, Inc.
- Andrew Ho Keung Tang
All providers in Stateline, NV · Mental Health Clinic/Center (Including Community Mental Health Center) in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.