Basic Information
| Provider Information | |||||||||
| NPI: | 1174766687 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VETRERAN AFFAIRS ADMINISTRATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1233 HUMBOLDT ST | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895092731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752322498 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 LOCUST STREET | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757867200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2009 | ||||||||
| LastUpdateDate: | 04/14/2009 | ||||||||
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| AuthorizedOfficialLastName: | LOPEZ | ||||||||
| AuthorizedOfficialFirstName: | JUDITH | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER EMERGENCY DEPARTMENT | ||||||||
| AuthorizedOfficialTelephone: | 7753281219 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 313M00000X | RN53257 | NV | Y | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |
No ID Information.