Provider Demographics
NPI:1841761301
Name:JHOANNA T MANALO
Entity Type:Organization
Organization Name:JHOANNA T MANALO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JHOANNA
Authorized Official - Middle Name:T
Authorized Official - Last Name:MANALO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-762-2522
Mailing Address - Street 1:1435 AKARD DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-3121
Mailing Address - Country:US
Mailing Address - Phone:775-762-2522
Mailing Address - Fax:
Practice Address - Street 1:1435 AKARD DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-3121
Practice Address - Country:US
Practice Address - Phone:775-747-1433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV57Medicaid