Provider Demographics
NPI:1063859072
Name:TAHOE YOUTH AND FAMILY SERVICES
Entity Type:Organization
Organization Name:TAHOE YOUTH AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CROFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-782-4202
Mailing Address - Street 1:1512 HWY 395 N
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410-5239
Mailing Address - Country:US
Mailing Address - Phone:775-782-4202
Mailing Address - Fax:775-782-5055
Practice Address - Street 1:948 INCLINE WAY
Practice Address - Street 2:
Practice Address - City:INCLINE VILLAGE
Practice Address - State:NV
Practice Address - Zip Code:89451-9527
Practice Address - Country:US
Practice Address - Phone:775-298-0275
Practice Address - Fax:775-782-5055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAHOE YOUTH & FAMILY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-30
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVC29935-2002251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable