Provider Demographics
NPI:1801243803
Name:PSYCHIATRY & WELLNESS OF RENO, CHARLES, CHARLES BROOKS PC
Entity type:Organization
Organization Name:PSYCHIATRY & WELLNESS OF RENO, CHARLES, CHARLES BROOKS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-525-1095
Mailing Address - Street 1:PO BOX 34481
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89533-4481
Mailing Address - Country:US
Mailing Address - Phone:775-525-1095
Mailing Address - Fax:
Practice Address - Street 1:243 STEWART ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-2235
Practice Address - Country:US
Practice Address - Phone:775-525-1095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty