Provider Demographics
NPI:1700173077
Name:TAHOE YOUTH AND FAMILY SERVICES
Entity type:Organization
Organization Name:TAHOE YOUTH AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHEYANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-541-2445
Mailing Address - Street 1:1512 HWY 395 N.
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410-5239
Mailing Address - Country:US
Mailing Address - Phone:775-782-4202
Mailing Address - Fax:775-782-5055
Practice Address - Street 1:1512 HWY 395 N.
Practice Address - Street 2:SUITE 3
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5239
Practice Address - Country:US
Practice Address - Phone:775-782-4202
Practice Address - Fax:775-782-5055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251X00000XAgenciesSupports Brokerage