Provider Demographics
NPI:1457515850
Name:BRISTLECONE FAMILY RESOURCES
Entity Type:Organization
Organization Name:BRISTLECONE FAMILY RESOURCES
Other - Org Name:BRISTLECONE RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:OTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-954-1400
Mailing Address - Street 1:704 MILL ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1321
Mailing Address - Country:US
Mailing Address - Phone:775-954-1400
Mailing Address - Fax:775-954-1406
Practice Address - Street 1:704 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1321
Practice Address - Country:US
Practice Address - Phone:775-954-1400
Practice Address - Fax:775-954-1406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility