Provider Demographics
NPI:1295248540
Name:COMMUNITY MENTAL HEALTH INC
Entity type:Organization
Organization Name:COMMUNITY MENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:775-857-9599
Mailing Address - Street 1:6005 PLUMAS ST STE 100
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-6068
Mailing Address - Country:US
Mailing Address - Phone:775-857-9599
Mailing Address - Fax:775-800-1311
Practice Address - Street 1:160 HUBBARD WAY STE E
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3780
Practice Address - Country:US
Practice Address - Phone:775-432-1700
Practice Address - Fax:775-800-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01260106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty