Provider Demographics
NPI:1013295294
Name:BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION
Entity Type:Organization
Organization Name:BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION
Other - Org Name:MOJAVE TCM NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE CHANCELOR ADMINISTRATIVE & LEG
Authorized Official - Prefix:
Authorized Official - First Name:BART
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-889-8426
Mailing Address - Street 1:745 W. MOANA LANE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509
Mailing Address - Country:US
Mailing Address - Phone:702-968-5059
Mailing Address - Fax:702-968-4041
Practice Address - Street 1:745 W. MOANA LANE
Practice Address - Street 2:SUITE 100
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509
Practice Address - Country:US
Practice Address - Phone:775-334-3033
Practice Address - Fax:775-334-3022
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOARD OF REGENTS NEVADA SYSTEM OF HIGHER EDUCATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)