Provider Demographics
NPI: | 1952665960 |
---|---|
Name: | CARSON TAHOE BEHAVIORAL HEALTH SERVICES |
Entity Type: | Organization |
Organization Name: | CARSON TAHOE BEHAVIORAL HEALTH SERVICES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OFFICE MANAGER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | DEBORAH |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BORGES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 775-445-7756 |
Mailing Address - Street 1: | 775 FLEISCHMANN WAY |
Mailing Address - Street 2: | |
Mailing Address - City: | CARSON CITY |
Mailing Address - State: | NV |
Mailing Address - Zip Code: | 89703-2995 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 775-445-7756 |
Mailing Address - Fax: | 775-841-0304 |
Practice Address - Street 1: | 775 FLEISCHMANN WAY |
Practice Address - Street 2: | |
Practice Address - City: | CARSON CITY |
Practice Address - State: | NV |
Practice Address - Zip Code: | 89703-2995 |
Practice Address - Country: | US |
Practice Address - Phone: | 775-445-7756 |
Practice Address - Fax: | 775-841-0304 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-06-25 |
Last Update Date: | 2012-06-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NV | 5827-S | 273R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 273R00000X | Hospital Units | Psychiatric Unit |