Provider Demographics
NPI:1710499652
Name:HARNESS, RICK
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:HARNESS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7955 RUSTY RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1084
Mailing Address - Country:US
Mailing Address - Phone:775-250-2668
Mailing Address - Fax:
Practice Address - Street 1:1575 E LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-8989
Practice Address - Country:US
Practice Address - Phone:775-250-2668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care