Provider Demographics
NPI:1093421943
Name:THE DIFFERENCE AT MOUNT ROSE
Entity Type:Organization
Organization Name:THE DIFFERENCE AT MOUNT ROSE
Other - Org Name:THE DIFFERENTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SMYLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-308-4169
Mailing Address - Street 1:5950 ROCK FARM RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-8238
Mailing Address - Country:US
Mailing Address - Phone:928-308-4169
Mailing Address - Fax:
Practice Address - Street 1:5950 ROCK FARM RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-8238
Practice Address - Country:US
Practice Address - Phone:928-308-4169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder