WAGONEER GROUP CARE (NPI# 1245785203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245785203 |
| Entity Type | Organization |
| Organization Name | WAGONEER GROUP CARE |
| Practice Address |
3705 Wagoneer Dr Reno NV 89502-5917 |
| Practice Telephone | 7754095675 |
| Practice Fax Number | 7758001836 |
| Mailing Telephone | 7754095675 |
| Mailing Fax Number | 7758001836 |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2016-08-19 |
| Authorized Official Name | BRENDA CLARETE FINK (OWNER ADMINISTRATOR) |
| Authorized Official Telephone | 7758256876 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 9005046915 | 9005046915 | 01 |
| Street Address |
3705 WAGONEER DR |
| City | RENO |
| State | NV |
| Zip Code | 89502-5917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314264 | State of Nevada | Community/Behavioral Health | 4600 Kietzke Lane Bldg D, Reno, NV 89502 | 2020-07-23 |
| 1447879259 | Ryan Johnson | Student in an Organized Health Care Education/Training Program | 1155 Mill St. W-11, Reno, NV 89502 | 2020-04-11 |
| 1396378063 | Domingko Loney | Chore Provider | 1325 Air Motive Wat St 262, Reno, NV 89502 | 2020-02-20 |
| 1053954842 | Derek Craig | Home Health Aide | 1000 Havard Way #29, Reno, NV 89502 | 2019-10-24 |
| 1477108124 | Marisa Rachael Traversie | Nurse Practitioner | 910 Vista Boulevard, Sparks, NV 89502 | 2019-08-08 |
| 1912564675 | Patrick Llewellyn Merrill | Social Worker | 975 Kirman Ave - Ch 116, Reno, NV 89502 | 2019-05-28 |
| 1881154706 | Naresh Kumar Veerabattini | Student in an Organized Health Care Education/Training Program | 1155 Mill St, Renown Regional Medical Center, W11 Academic Department Offices, Reno, NV 89502 | 2019-03-25 |
| 1053899187 | Daphne London | Behavioral Analyst | 1325 Airmotive Way Ste 260, Reno, NV 89502 | 2018-07-31 |
| 1790271609 | Jennifer J Padolina | Optometrist | 2296 Kietzke Ln, Reno, NV 89502 | 2018-07-03 |
| 1336630185 | Lindsey Cherie Cooper | Technician | 3563 Sol Grande Ct, Reno, NV 89502 | 2018-05-27 |
| Find all providers in zip 89502 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073147922 | Valley of Golden Ages Corp. | Custodial Care Facility | 2680 Margaret Dr, Reno, NV 89506-8651 | 2020-03-01 |
| 1114562667 | Longevity Residential Care II | Custodial Care Facility | 4073 Kings Row, Reno, NV 89503-6825 | 2019-11-07 |
| 1225694730 | Rocking J & L Company | Custodial Care Facility | 2690 Trail Rider Dr, Reno, NV 89521-8008 | 2019-05-10 |
| 1922661834 | Golden Years Castle Property Holdings LLC | Custodial Care Facility | 5175 Sleepy Hollow Dr, Reno, NV 89502-9699 | 2019-04-16 |
| 1790246635 | La Familia Homes Dba Serenity Senior Care | Custodial Care Facility | 3645 Rio Poco Rd, Reno, NV 89502-5349 | 2019-03-25 |
| 1720545916 | Nelia Buendia | Custodial Care Facility | 5325 Vista Larga Cir, Reno, NV 89523-1815 | 2019-02-25 |
| 1336605104 | Better Samaritan Inc | Custodial Care Facility | 10515 Kenai Dr, Reno, NV 89521-8319 | 2019-02-15 |
| 1720556293 | Jhoanna Manalo | Custodial Care Facility | 1435 Akard Dr, Reno, NV 89503-3121 | 2018-11-02 |
| 1326513250 | Starlight Group Home, LLC | Custodial Care Facility | 2301 E 9th St, Reno, NV 89512-3201 | 2018-10-07 |
| 1174005987 | Sierra Intelligence Group, LLC | Custodial Care Facility | 4190 Bismarck Dr, Reno, NV 89502-6306 | 2018-08-29 |
| Find all providers in RENO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.