NPI 1740580612

Childandfamilyservices

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Sparks, NV

Practice location

Address: 480 Galletti Way, Sparks, NV 89431-5564
Phone: (775) 688-1633
Mailing address: 480galletti Way Bldg 9, Sparks, NV 89431

Authorised official

Name: Ryan Gustafson
Title: Program Manger
Phone: (775) 688-1633

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 7777777 (NV)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Nevada →

Registry record

NPI: 1740580612
Entity type: Organization
NPI issued: 26 Oct 2010
Record last updated: 26 Oct 2010

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.