1730287319 NPI number — BHC HEALTH SERVICES OF NEVADA INC

Table of content: (NPI 1730287319)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730287319 NPI number — BHC HEALTH SERVICES OF NEVADA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BHC HEALTH SERVICES OF NEVADA INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730287319
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1240 E 9TH ST
Provider Second Line Business Mailing Address:
P.O. BOX 30012
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89512-2964
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-323-0478
Provider Business Mailing Address Fax Number:
775-789-4260

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1240 E 9TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RENO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89512-2964
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-323-0478
Provider Business Practice Location Address Fax Number:
775-789-4260
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FILTON
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
Authorized Official Title or Position:
SR VP CFO
Authorized Official Telephone Number:
610-768-3300

Provider Taxonomy Codes

  • Taxonomy code: 283Q00000X , with the licence number:  632H05-14 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001316900 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004216900 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: HSP230768 . This is a "MEDI-CAL PROVIDER NUMBER" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: HSM230768 . This is a "MEDI-CAL PROVIDER NUMBER" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




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