Provider Demographics
NPI:1932569472
Name:UNITED CEREBRAL PALSY OF NEVADA
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSBROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-322-6555
Mailing Address - Street 1:740 FREEPORT BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-6168
Mailing Address - Country:US
Mailing Address - Phone:775-322-6555
Mailing Address - Fax:775-236-0181
Practice Address - Street 1:740 FREEPORT BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-6168
Practice Address - Country:US
Practice Address - Phone:775-322-6555
Practice Address - Fax:775-236-0181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005040363Medicaid