Provider Demographics
NPI:1477637684
Name:CASA DE VIDA
Entity Type:Organization
Organization Name:CASA DE VIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LUEVANO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LSW
Authorized Official - Phone:775-329-3211
Mailing Address - Street 1:1290 MILL STREET
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1410
Mailing Address - Country:US
Mailing Address - Phone:775-329-1070
Mailing Address - Fax:775-329-9703
Practice Address - Street 1:1290 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1410
Practice Address - Country:US
Practice Address - Phone:775-329-1070
Practice Address - Fax:775-329-9703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health