Provider Demographics
NPI:1801314828
Name:CITY OF CARSON CITY
Entity type:Organization
Organization Name:CITY OF CARSON CITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-887-2033
Mailing Address - Street 1:740 SOUTH SALIMAN ROAD
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701
Mailing Address - Country:US
Mailing Address - Phone:775-877-2033
Mailing Address - Fax:775-887-2036
Practice Address - Street 1:740 S SALIMAN RD
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-5097
Practice Address - Country:US
Practice Address - Phone:775-877-2033
Practice Address - Fax:775-887-2036
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF CARSON CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0000000007Medicaid