Provider Demographics
NPI:1215580881
Name:TURNING TIDES THERAPY & MEDIATION DBA: CENTER FOR THERAPY & MEDIATION
Entity Type:Organization
Organization Name:TURNING TIDES THERAPY & MEDIATION DBA: CENTER FOR THERAPY & MEDIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUANRUD GRIMSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:775-842-5669
Mailing Address - Street 1:180 W HUFFAKER LN STE 302
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2091
Mailing Address - Country:US
Mailing Address - Phone:775-842-5669
Mailing Address - Fax:775-501-8783
Practice Address - Street 1:180 W HUFFAKER LN STE 302
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2091
Practice Address - Country:US
Practice Address - Phone:775-842-5669
Practice Address - Fax:775-501-8783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2019-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1083077887Medicaid