STATE OF NEVADA (NPI# 1972501021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972501021 |
| Entity Type | Organization |
| Organization Name | STATE OF NEVADA |
| Other Organization Name | NORTHERN NEVADA ADULT MENTAL HEALTH SERVICES |
| Practice Address |
480 Galletti Way Sparks NV 89431-5564 |
| Mailing Address |
4150 Technology Way Carson City NV 89706-2026 |
| Practice Telephone | 7756882001 |
| Practice Fax Number | 7756882192 |
| Mailing Telephone | 7756882001 |
| Mailing Fax Number | 7756882192 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2017-01-13 |
| Authorized Official Name | MR. MICHAEL ALLERDYCE (RATES AND COST CONTAINMENT MANAGER) |
| Authorized Official Telephone | 7756845952 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 283Q00000X | Psychiatric Hospital | Hospitals | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
652HOS-14 | NV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 100501303 | 05 | |
| NV | 001316864 | 05 | |
| NV | 002816864 | 05 | |
| NV | 001416864 | 05 | |
| NV | 002016864 | 05 | |
| NV | 005416864 | 05 | |
| NV | 100503395 | 05 |
| Other Name | Type Code |
|---|---|
| Northern Nevada Adult Mental Health Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314264 | State of Nevada | Community/Behavioral Health | 4600 Kietzke Lane Bldg D, Reno, NV 89502 | 2020-07-23 |
| 1821607193 | State of Nevada | Community/Behavioral Health | 6171 W Charleston Blvd Bldg 15, Las Vegas, NV 89146 | 2020-07-23 |
| 1316574064 | State of Nevada | Psychiatric Residential Treatment Facility | 2655 Enterprise Dr, Reno, NV 89512 | 2020-03-24 |
| 1114309432 | State of Nevada | Case Management | 3416 Goni Rd Bldg D, 132, Carson City, NV 89706-8008 | 2015-06-23 |
| 1699914887 | State of Nevada | Case Management | 775 Cornell Avenue, Suite A-1, Lovelock, NV 89419-0000 | 2009-02-11 |
| 1386805265 | State of Nevada | Public Health or Welfare | 1000 E Williams Street, #205, Carson City, NV 80701 | 2008-06-23 |
| 1558549972 | State of Nevada | Case Management | 100 Depot, #5, Caliente, NV 89008-0000 | 2008-02-07 |
| 1578741179 | State of Nevada | Case Management | 1665 Old Hot Springs Road, Suite 150, Carson City, NV 89706-0668 | 2008-02-06 |
| 1336203892 | State of Nevada | Public Health or Welfare | 1665 Old Hot Springs Rd Ste 157, Carson City, NV 89706-0663 | 2006-12-20 |
| 1184706012 | State of Nevada | Clinic/Center | 825 S Main, Tonopah, NV 89049-0494 | 2006-10-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | STATE OF NEVADA RURAL CLINICS | 4126 Technology Way 2nd Fl, Carson City, NV 89706-2027 |
| Street Address |
480 GALLETTI WAY |
| City | SPARKS |
| State | NV |
| Zip Code | 89431-5564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760022214 | Dr. William Jackson | Clinic/Center | 480 Galletti Way, Sparks, NV 89431-5564 | 2020-01-13 |
| 1124676614 | Bryon Jason Gallant | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2019-08-28 |
| 1063076578 | David R Ball | Day Training/Habilitation Specialist | 480 Galletti Way, Sparks, NV 89431-5564 | 2019-04-30 |
| 1154893980 | Juan Manuel Juarez Jr. | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-12-18 |
| 1861962805 | Ange Kay Zimmerman | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-12-03 |
| 1053887588 | Richard Alexander Noack | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-10-23 |
| 1053886739 | Jessica Kate Ketz | Case Manager/Care Coordinator | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-10-09 |
| 1720563497 | Colleen Patricia Haesche | Case Manager/Care Coordinator | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-09-28 |
| 1457839797 | Mitchell Stuart Lasco | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-07-30 |
| 1548752686 | Tyler Rosentreter | Counselor | 480 Galletti Way, Sparks, NV 89431-5564 | 2018-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053958033 | Jerome Johnson II | Behavioral Analyst | 3115 Saltern Way, Sparks, NV 89431 | 2019-12-09 |
| 1528520640 | Dynisha Bernee Richardson | Technician, Other | 616 Victorian Ave, Sparks, NV 89431 | 2019-04-05 |
| 1902376494 | Avalon Care Center-va Reno, LLC | Skilled Nursing Facility | 36 Battle Born Way, Sparks, NV 89431 | 2018-11-28 |
| 1669964128 | Abraham A Arellano | Behavioral Analyst | 2005 Probasco Way, Sparks, NV 89431 | 2018-05-31 |
| 1003335399 | Carresa Greer | Counselor | 390 Freeport Blvd #3, Sparks, NV 89431 | 2017-09-18 |
| 1689197444 | Fred Blauth Jr. | Counselor | 2105 Sullivan Ln, Sparks, NV 89431 | 2017-07-24 |
| 1548719255 | Adolescent Treatment Center | Community Based Residential Treatment Facility, Mental Illness | 480 Galetti Way, Sparks, NV 89431 | 2016-09-23 |
| 1124478862 | Kristina Schneider | Behavioral Analyst | 3230 Wedekind Rd, 50, Sparks, NV 89431 | 2016-06-14 |
| 1336506898 | Rikki Texter | Occupational Therapy Assistant | 1025 Robert Lane, Sparks, NV 89431 | 2016-01-28 |
| 1851760177 | Elizabeth Ojeda | Counselor | 490 Galletti Way, Building 8c, Sparks, NV 89431 | 2015-09-16 |
| Find all providers in zip 89431 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760022214 | Dr. William Jackson | Clinic/Center | 480 Galletti Way, Sparks, NV 89431-5564 | 2020-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244010 | Serenity Counseling Services | Clinic/Center | 505 S Arlington Ave Ste 203, Reno, NV 89509-1525 | 2020-10-30 |
| 1538775416 | Schonian Wellness Group, LLC | Clinic/Center | 9017 S Pecos Rd Ste 4330, Henderson, NV 89074-7196 | 2020-09-16 |
| 1215558143 | Jessica Mix Mft | Clinic/Center | 6390 W Cheyenne Ave Ste F, Las Vegas, NV 89108-6008 | 2020-05-01 |
| 1528695897 | L Jensen and Associates Inc | Clinic/Center | 9418 W Lake Mead Blvd Ste 308, Las Vegas, NV 89134-8312 | 2020-03-25 |
| 1013548817 | Abraxas Center LLC | Clinic/Center | 4575 W Cougar Ave Ste 300, Las Vegas, NV 89139-7617 | 2020-01-30 |
| 1164061818 | Therapy Sense Pllc | Clinic/Center | 9402 W Lake Mead Blvd Ofc 104, Las Vegas, NV 89134-8312 | 2019-12-28 |
| 1932748779 | Mindworks Mental Health Clinic | Clinic/Center | 3830 Timberlake Dr., Las Vegas, NV 89115 | 2019-12-26 |
| 1205479813 | Core Strength LLC | Clinic/Center | 186 Woolman Rink Ave, Las Vegas, NV 89123-7443 | 2019-10-26 |
| 1164987871 | Brenda Primero Np LLC | Clinic/Center | 8125 Nottingham Hill Ln, Las Vegas, NV 89113-1888 | 2019-02-06 |
| 1942773775 | Best Life Behavioral Health LLC | Clinic/Center | 1970 E 2nd St, Reno, NV 89502-1223 | 2019-01-03 |
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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.