NPI 1114309432
State of Nevada
Practice location
- Address
- 3416 Goni Rd Bldg D 132, Carson City, NV 89706-8008
- Phone
- (775) 687-4210
- Fax
- (775) 687-0574
Authorised official
- Name
- Jill Berntson
- Title
- Deputy Administrator
- Phone
- (775) 687-0534
Registered specialties
Case Management Agency
Primary
Registry record
- NPI
- 1114309432
- Entity type
- Organization
- NPI issued
- 23 Jun 2015
- Record last updated
- 23 Jun 2015
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.