Provider Demographics
NPI:1669817912
Name:ROBISON HOUSE RENO LLC
Entity Type:Organization
Organization Name:ROBISON HOUSE RENO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUKE
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:775-355-7722
Mailing Address - Street 1:550 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-1450
Mailing Address - Country:US
Mailing Address - Phone:775-355-7722
Mailing Address - Fax:775-355-7116
Practice Address - Street 1:550 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-1450
Practice Address - Country:US
Practice Address - Phone:775-355-7722
Practice Address - Fax:775-355-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0369106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty