Provider Demographics
NPI:1942829932
Name:HEALTHY NEVADA
Entity Type:Organization
Organization Name:HEALTHY NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD STRATEGIST
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-283-4575
Mailing Address - Street 1:212 W WALNUT ST STE B
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-2341
Mailing Address - Country:US
Mailing Address - Phone:417-283-4575
Mailing Address - Fax:
Practice Address - Street 1:212 W WALNUT ST STE B
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-2341
Practice Address - Country:US
Practice Address - Phone:417-283-4575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare