Provider Demographics
NPI:1609361088
Name:DOUGLAS COUNTY AND UNINCORPORATED TOWNS
Entity Type:Organization
Organization Name:DOUGLAS COUNTY AND UNINCORPORATED TOWNS
Other - Org Name:CHINA SPRING YOUTH CAMP ADAPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:COLLEEN
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-265-5350
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-0218
Mailing Address - Country:US
Mailing Address - Phone:775-265-5350
Mailing Address - Fax:
Practice Address - Street 1:CHINA SPRING YOUTH CAMP ADAPT
Practice Address - Street 2:225 CHINA SPRING ROAD
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410
Practice Address - Country:US
Practice Address - Phone:775-265-5635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children