Provider Demographics
NPI:1124219712
Name:HEALTHERAPY OF NEVADA
Entity Type:Organization
Organization Name:HEALTHERAPY OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-443-8302
Mailing Address - Street 1:680 W NYE LN
Mailing Address - Street 2:102
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-1541
Mailing Address - Country:US
Mailing Address - Phone:775-884-9911
Mailing Address - Fax:775-884-9913
Practice Address - Street 1:680 W NYE LN
Practice Address - Street 2:102
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-1541
Practice Address - Country:US
Practice Address - Phone:775-884-9911
Practice Address - Fax:775-884-9913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100511791Medicaid