Provider Demographics
NPI:1790293355
Name:CORAZON A CORAZON BEHAVIOR HEALTH LLC
Entity Type:Organization
Organization Name:CORAZON A CORAZON BEHAVIOR HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ARACELI
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-507-7078
Mailing Address - Street 1:3100 MILL ST STE 215
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2217
Mailing Address - Country:US
Mailing Address - Phone:775-507-7078
Mailing Address - Fax:775-507-7079
Practice Address - Street 1:3100 MILL ST STE 215
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-507-7078
Practice Address - Fax:775-507-7079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities