State of Nevada

NPI #1992887822 in Stateline, Nevada

Provider Information

NPI Number: 1992887822
Entity Type: Organization
Organization Name: State of Nevada
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Oct 19, 2006
Last Updated: Oct 10, 2007

Practice Location

Address: 175 W US HIGHWAY 50
City: Stateline
State: Nevada
ZIP Code: 89779
Phone: (775) 687-3671

Authorized Official

Name: MR. RAY C KENDALL, LCSW
Title: AGENCY DIRECTOR
Phone: (775) 687-7500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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