Provider Demographics
NPI:1235596065
Name:COMMUNITY CHEST, INC.
Entity Type:Organization
Organization Name:COMMUNITY CHEST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:SUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC, LCADC
Authorized Official - Phone:775-847-0414
Mailing Address - Street 1:PO BOX 980
Mailing Address - Street 2:175 EAST CARSON STREET
Mailing Address - City:VIRGINIA CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89440
Mailing Address - Country:US
Mailing Address - Phone:775-847-0414
Mailing Address - Fax:775-848-9335
Practice Address - Street 1:175 EAST CARSON STREET
Practice Address - Street 2:SUITE A
Practice Address - City:VIRGINIA CITY
Practice Address - State:NV
Practice Address - Zip Code:89440
Practice Address - Country:US
Practice Address - Phone:775-847-0414
Practice Address - Fax:775-847-9335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV19911013020251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health